中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2014年
3期
188-191
,共4页
郝晓晖%姚岚%孙华%刘一典%唐神结
郝曉暉%姚嵐%孫華%劉一典%唐神結
학효휘%요람%손화%류일전%당신결
结核,肺%老年人%结核,抗多种药物性
結覈,肺%老年人%結覈,抗多種藥物性
결핵,폐%노년인%결핵,항다충약물성
Tuberculosis,pulmonary%Aged%Tuberculosis,multidrug-resistant
目的 探讨老年耐多药肺结核的临床特征及其转归.方法 采用回顾性研究方法,收集上海市肺科医院2007年1月至2010年1月收治的139例耐多药肺结核患者,其中65岁以上老年患者59例(老年组),18 ～64岁中青年患者80例(中青年组).记录2组患者的一般临床资料及临床疗效转归、不良反应等.两组间比较采用x2检验.结果 老年组的临床症状除气促明显外,与中青年组没有明显差别.老年组中复治患者(96.6％,57/59)显著多于中青年组(86.3％,69/80),差异有统计学意义(x2 =4.299,P＜0.05),老年组的病灶广泛,波及5～6个肺野的患者(57.6％,34/59)显著多于中青年组(22.5％,18/80),治愈率(28.8％,17/59)显著低于中青年组(51.3％,41/80),病死率(17.0％,10/59)显著多于中青年组(3.4％,3/80),差异均有统计学意义(x2值为6.837～17.894,均P ＜0.01).老年组肝、肾功能损伤发生率分别为23.7％(14/59)和10.2％ (6/59),显著高于中青年组的10.0％(8/80)和1.3％ (1/80),差异均有统计学意义(x2值分别为4.804和5.649,均P＜0.05).结论 老年耐多药肺结核患者的病灶广泛,复治病例较多,不良反应发生率较高,临床治愈率较低,病死率较高.
目的 探討老年耐多藥肺結覈的臨床特徵及其轉歸.方法 採用迴顧性研究方法,收集上海市肺科醫院2007年1月至2010年1月收治的139例耐多藥肺結覈患者,其中65歲以上老年患者59例(老年組),18 ～64歲中青年患者80例(中青年組).記錄2組患者的一般臨床資料及臨床療效轉歸、不良反應等.兩組間比較採用x2檢驗.結果 老年組的臨床癥狀除氣促明顯外,與中青年組沒有明顯差彆.老年組中複治患者(96.6％,57/59)顯著多于中青年組(86.3％,69/80),差異有統計學意義(x2 =4.299,P＜0.05),老年組的病竈廣汎,波及5～6箇肺野的患者(57.6％,34/59)顯著多于中青年組(22.5％,18/80),治愈率(28.8％,17/59)顯著低于中青年組(51.3％,41/80),病死率(17.0％,10/59)顯著多于中青年組(3.4％,3/80),差異均有統計學意義(x2值為6.837～17.894,均P ＜0.01).老年組肝、腎功能損傷髮生率分彆為23.7％(14/59)和10.2％ (6/59),顯著高于中青年組的10.0％(8/80)和1.3％ (1/80),差異均有統計學意義(x2值分彆為4.804和5.649,均P＜0.05).結論 老年耐多藥肺結覈患者的病竈廣汎,複治病例較多,不良反應髮生率較高,臨床治愈率較低,病死率較高.
목적 탐토노년내다약폐결핵적림상특정급기전귀.방법 채용회고성연구방법,수집상해시폐과의원2007년1월지2010년1월수치적139례내다약폐결핵환자,기중65세이상노년환자59례(노년조),18 ～64세중청년환자80례(중청년조).기록2조환자적일반림상자료급림상료효전귀、불량반응등.량조간비교채용x2검험.결과 노년조적림상증상제기촉명현외,여중청년조몰유명현차별.노년조중복치환자(96.6％,57/59)현저다우중청년조(86.3％,69/80),차이유통계학의의(x2 =4.299,P＜0.05),노년조적병조엄범,파급5～6개폐야적환자(57.6％,34/59)현저다우중청년조(22.5％,18/80),치유솔(28.8％,17/59)현저저우중청년조(51.3％,41/80),병사솔(17.0％,10/59)현저다우중청년조(3.4％,3/80),차이균유통계학의의(x2치위6.837～17.894,균P ＜0.01).노년조간、신공능손상발생솔분별위23.7％(14/59)화10.2％ (6/59),현저고우중청년조적10.0％(8/80)화1.3％ (1/80),차이균유통계학의의(x2치분별위4.804화5.649,균P＜0.05).결론 노년내다약폐결핵환자적병조엄범,복치병례교다,불량반응발생솔교고,림상치유솔교저,병사솔교고.
Objective To investigate the clinical curative effect and outcomes of multidrug-resistant tuberculosis (MDR-TB) in elderly patients.Methods Fifty-nine elderly patients with MDR-TB were enrolled from Shanghai Pulmonary Hospital from January 2007 to January 2010,and 80 younger patients with MDR-TB during the same period served as the control group.Clinical characteristics,outcomes and adverse effects of treatment were reviewed,and the data of the 2 groups were compared using cohort analysis.Comparisons of categorical variables were performed using the Pearson Chi-square tests,and differences between groups were compared by Fisher' s exact test.Results Compared with those of the younger patients,the clinical symptoms of the elderly patients showed no significant differences except shortness of breath.The proportion of retreated patients in the elderly patients (96.6％,57/59) was significantly higher than that in the younger group (86.3％,69/80) (x2 =4.299,P ＜0.05).The proportion of the patients with lesions involving 5-6 lung fields in the elderly group was 57.6％ (34/59),higher than that in the younger group (22.5％,18/80) (x2 =17.894,P ＜ 0.01).The treatment success rate in the elderly MDR-TB group was 28.2％ (17/59),lower than that in the younger group (51.3％,41/80) (x2 =7.029,P ＜0.01).The death rate in the elderly group was 17.0％ (10/59),significantly higher than that in the younger group (3.4％,3/80) (x2 =6.837-17.894,P ＜ 0.05).The incidence of liver injury in the elderly group was higher than that in the younger group (23.7％,14/59 vs 10.0％,8/80,x2 =4.804,P＜0.05),and so was that of kidney dysfunction (10.2％,6/59 vs 1.3％,1/80,x2 =5.649,P ＜ 0.05).Conclusions In elderly patients with MDR-TB,the pulmonary lesions were extensive,the number of retreated cases was higher,and the incidence of adverse drug reactions was also higher.The treatment success rate was lower while the mortality rate was higher for elderly patients with MDR-TB.
