CAJ | 학술논문

目的：研究老年慢性阻塞性肺疾病合并肺结核感染的临床表现，指导临床诊断和治疗老年慢性阻塞性肺疾病合并肺结核感染的临床观察。方法回顾性分析2012年1月－2013年10月在医院进行诊治的老年慢性阻塞性肺疾病合并肺结核感染的患者92例，48例患者具备典型的肺结核症状的老年慢性阻塞性肺疾病患者视为治疗组，对于初治患者采用2RHZE／4HR方案，对于复治患者采用3DLVE／6DLE治疗方案；44例不具备典型肺结核症状的老年慢性阻塞性肺疾病患者，按一般的慢性阻塞性肺疾病进行治疗为对照组，对比两组患者临床指标，数据采用SPSS13．0进行统计分析。结果经过15～30 d的治疗后，治疗组患者中双肺斑片状阴影消失的34例占70．8％，44例对照组患者中双肺斑片状阴影消失的患者12例占29．2％，经检验治疗组患者双肺斑片状阴影消失的比例明显高于对照组，差异有统计学意义（ P＜0．05％）；48例治疗组患者中空洞闭合或缩小的患者13例占27．1％，44例对照组患者中空洞闭合或缩小的患者26例占59．1％，经检验治疗组患者空洞闭合或缩小的比例明显低于对照组，差异有统计学意义（ P＜0．05％）。结论应加强对老年慢性阻塞性肺疾病合并肺结核感染的临床诊断，对于确诊的患者，临床医护人员应根据老年患者自身的情况，制定相应的化疗方案，选择不良反应小的抗结核药物对老年慢性阻塞性肺疾病合并肺结核的患者进行长期的治疗。
목적：연구노년만성조새성폐질병합병폐결핵감염적림상표현，지도림상진단화치료노년만성조새성폐질병합병폐결핵감염적림상관찰。방법회고성분석2012년1월－2013년10월재의원진행진치적노년만성조새성폐질병합병폐결핵감염적환자92례，48례환자구비전형적폐결핵증상적노년만성조새성폐질병환자시위치료조，대우초치환자채용2RHZE／4HR방안，대우복치환자채용3DLVE／6DLE치료방안；44례불구비전형폐결핵증상적노년만성조새성폐질병환자，안일반적만성조새성폐질병진행치료위대조조，대비량조환자림상지표，수거채용SPSS13．0진행통계분석。결과경과15～30 d적치료후，치료조환자중쌍폐반편상음영소실적34례점70．8％，44례대조조환자중쌍폐반편상음영소실적환자12례점29．2％，경검험치료조환자쌍폐반편상음영소실적비례명현고우대조조，차이유통계학의의（ P＜0．05％）；48례치료조환자중공동폐합혹축소적환자13례점27．1％，44례대조조환자중공동폐합혹축소적환자26례점59．1％，경검험치료조환자공동폐합혹축소적비례명현저우대조조，차이유통계학의의（ P＜0．05％）。결론응가강대노년만성조새성폐질병합병폐결핵감염적림상진단，대우학진적환자，림상의호인원응근거노년환자자신적정황，제정상응적화료방안，선택불량반응소적항결핵약물대노년만성조새성폐질병합병폐결핵적환자진행장기적치료。
OBJECTIVE To observe the clinical manifestation of elderly patients with chronic obstructive pulmonary disease (COPD) combined with tuberculosis ,and provide some knowledge for diagnosis and treatment of elderly COPD patients combined with tuberculosis .METHODS Totally 92 cases of elderly COPD patients combined with tuberculosis treated during Jan .2012 to Oct .2013 were chosen ,among which 48 patients with obvious tuberculo‐sis symptoms was set as the treatment group and 44 patients without obvious tuberculosis symptoms as the control group .The patients of first visit in the treatment group were treated with 2RHZE/4HR regimen and the patients of return visit treated with 3DLVE/6DLE regimen .The control group received routine treatment for common COPD .Clinical indexes were compared between the two groups and the software SPSS13 .0 was used for statistical analysis .RESULTS After 15~30 days of treatment ,bilateral patchy shadows disappeared in 34 cases (70 .8% ) in the treatment group and 12 cases (29 .2% ) in the control group .And the analysis confirmed that the ratio of patchy shadow disappearance was higher in the treatment group than in the control group ,the difference was sig‐nificant (P<0 .5) .Cavity closure or reduction occurred in 13 cases (27 .1% ) in the treatment group and 26 cases in the control group .And the analysis confirmed that the ratio of cavity closure or reduction was lower in the treatment group than in the control group ,the difference was significant (P<0 .5) .CONCLUSION Medical staffs should be careful in diagnosis and treatment for elderly COPD patients combined with tuberculosis .And for pa‐tients diagnosed as COPD combined with tuberculosis ,corresponding individual chemotherapy and antitubercular drugs with low adverse events should be chosen for treatment .