CAJ | 학술논문

目的：分析不典型结核分枝杆菌感染的特点，以提高结核病的临床诊断水平。方法回顾性分析武汉协和医院2005年1月至2012年12月收治的以发热为主要表现并且经诊断性抗结核治疗确诊的79例结核病患者的临床资料。结果本组患者均以发热为主要临床表现，而午后潮热、盗汗和消瘦等结核分枝杆菌感染的临床症状多不明显。其中多数患者的检查结果显示如下特点：白细胞计数多正常或降低（占84.8%），超敏C-反应蛋白升高（占84.0%），红细胞沉降率增快（占73.0%），糖蛋白抗原125（CA125）不同程度升高（占74.3%），影像学检查多提示浆膜腔积液或者淋巴结肿大（占44.3%）。目前临床常用的结核分枝杆菌感染的血清标志物检测价值有限。结论具备以上临床特点的发热患者需考虑结核分枝杆菌感染的可能，诊断性抗结核治疗有助于该病的确诊。
목적：분석불전형결핵분지간균감염적특점，이제고결핵병적림상진단수평。방법회고성분석무한협화의원2005년1월지2012년12월수치적이발열위주요표현병차경진단성항결핵치료학진적79례결핵병환자적림상자료。결과본조환자균이발열위주요림상표현，이오후조열、도한화소수등결핵분지간균감염적림상증상다불명현。기중다수환자적검사결과현시여하특점：백세포계수다정상혹강저（점84.8%），초민C-반응단백승고（점84.0%），홍세포침강솔증쾌（점73.0%），당단백항원125（CA125）불동정도승고（점74.3%），영상학검사다제시장막강적액혹자림파결종대（점44.3%）。목전림상상용적결핵분지간균감염적혈청표지물검측개치유한。결론구비이상림상특점적발열환자수고필결핵분지간균감염적가능，진단성항결핵치료유조우해병적학진。
Objective To investigate the clinical characteristics and diagnosis methods of atypical tuberculosis. Methods The clinical data of atypical tuberculosis patients with fever proved by diagnostic therapy from January 2005 to December 2012 in Wuhan Union Hospital were analyzed, retrospectively. Results The major clinical manifestation was fever, but tidal fever in the afternoon, fatigue, and weight loss were not common. The leukocyte counts were mostly normal or low (84.8%). Almost half of the patients showed elevated high sensitive of C-reactive protein (84.0%), erythrocyte sedimentation rate (73.0%) and carbohydrate antigen 125 (CA125) (74.3%). Polyserositis or lymphadenopathy was found in most of the patients (44.3%). At the present, serological tests had limited value in the diagnosis of tuberculosis. Conclusions The diagnosis of tuberculosis should be considered on patients with the above clinical characteristics. Therapeutic trial could provide correct diagnosis.