摘要
目的比较分析老年单纯肺结核患者与老年肺结核合并肺部真菌感染患者的临床特点,旨在为临床防治肺结核并发肺部真菌感染提供科学依据。方法对2005-2010年我院收治的166例老年单纯肺结核患者(Ⅰ组)和140例老年肺结核合并肺部真菌感染患者(Ⅱ组)的临床资料及相关因素进行回顾性分析,以探讨老年肺结核合并肺部真菌感染患者的临床特点。结果Ⅱ组患者生活条件较差、年龄较大、病程较长、临床表现严重、肺内病变范围大且以空洞和纤维化改变为主;患者多次入院治疗,而且耐2种以上抗结核药物者的比例达40.2%,与Ⅰ组患者相比差异有统计学意义。结论老年肺结核患者合并肺部真菌感染的主要原因有:(1)患者年龄较大、肺结核病程较长、生活条件较差致自身机体免疫功能和抵抗力低下;(2)结核菌侵蚀肺部广泛、病变严重,致患者肺部的病理改变有利于真菌生长繁殖;(3)不规范治疗或仅经过非正规治疗及滥用广谱抗生素、糖皮质激素、免疫抑制剂等致使结核菌产生耐药性且机体免疫力下降而有利于真菌感染。
Objective To compare the clinical features of pulmonary tuberculosis（TB）and TB with fungal infection（FI）in old population, and provide evidence for the prevention and treatment of TB with FI. Methods We collected and analyzed the clinical data of patients in our hospital from 2005 to 2010. They were divided into two groups：patients with single TB（group Ⅰ, 166）and patients with TB and FI（group Ⅱ,140）. Results Comparing with group Ⅰ, patients in group If showed worse living conditions, older age, longer duration of disease, more severe clinical manifestations,larger lesions and obvious empty and fibrosis. Besides, the times of hospitalization in group Ⅱwere more. The proportion of drug resistance of 2 or more anti-TB drugs was 40.2%. Differences between 2 groups were statistically significant. Conclusion The main reasons of TB with FI in old population include： （1）Decreased immunity results from poor living conditions, old age and long d u ration of disease, （2）TB infects pulmonary issue and causes serious pathological changes, that provides a favorable circumstance for Ff＇s growing, （3）Non-standard treatment, abuse of broad-spectrum antibiotics,corticosteroids and immunosuppressive agents lead to drug resistance and decreased immunity.
出处
《中国冶金工业医学杂志》
2012年第3期257-259,共3页
Chinese Medical Journal of Metallurgical industry
关键词
老年肺结核
肺部真菌感染
临床特点
Pulmonary tuberculosis in old population
Fungal infection of pulmonary
Clinical feature
