摘要
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）（。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．O％（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。
Objective To investigate the clinical curative effect and outcomes of muhidrug-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） （ ~5 = 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 eases 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.
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2014年第3期188-191,共4页
Chinese Journal of Tuberculosis and Respiratory Diseases
关键词
结核
肺
老年人
结核
抗多种药物性
Tuberculosis, pulmonary
Aged
Tuberculosis, multidrug-resistant
