摘要
目的分析流浪青年肺结核患者的临床特点,为结核病防控提供依据。方法回顾性分析2017年1月-2021年12月上海市松江区中心医院感染科收治住院的116例青年重症肺结核患者临床资料,根据人群特征分为流浪青年(n=35)和普通青年(n=81),比较2组患者一般人口学特征、临床症状、实验室检查、影像学表现、合并症及预后等差异。结果35例流浪青年肺结核患者有精神病(22.86%)比例明显高于普通青年(0.00%),差异有统计学意义(P<0.01);主要症状消瘦(100.00%)、乏力(100.00%)、咳嗽/咳痰(88.57%)及发热(88.57%)比例明显高于普通青年(18.52%、20.99%、61.73%、55.56%),差异均有统计学意义(P均<0.01);流浪青年患者均延迟就诊(100.00%),其中延迟超过3个月者占54.29%,显著高于普通青年(8.64%),差异有统计学意义(P<0.01)。流浪青年白细胞、C反应蛋白、降钙素原水平均较普通青年明显升高,血红蛋白及白蛋白水平均明显下降,痰涂片抗酸杆菌阳性率(100.00%)明显升高,差异均有统计学意义(P均<0.01)。流浪青年胸部影像学表现以多发空洞最常见(77.14%),占比较普通青年(41.98%)明显升高,差异有统计学意义(P<0.01)。流浪青年合并症以肺部感染(74.29%)、呼吸衰竭(40.00%)及休克(22.86%)最常见,占比均显著高于普通青年(18.52%、1.23%、0.00%),差异均有统计学意义(P均<0.01)。流浪青年出院时死亡10例,死亡率(28.57%)较普通青年(1.23%)显著升高,差异有统计学意义(P<0.01)。结论流浪青年肺结核患者延迟就诊率高,病情重,合并症多且死亡率高。
Objective To analyze the clinical characteristics of young homeless patients with pulmonary tuberculosis and provide evidence for the prevention and control of tuberculosis.Methods The clinical data of 116 young patients with severe pulmonary tuberculosis admitted to the Department of Infection of Shanghai Songjiang District Central Hospital from January 2017 to December 2021 were retrospectively analyzed.According to the characteristics of the population,they were divided into homeless youth(n=35)and general youth(n=81).The general demographic,clinical symptoms,laboratory examination,imaging findings,complications and prognosis of the two youths were compared.Results The proportion of mental illness(22.86%)of homeless youth was significantly higher than that of general youth(0.00%),the difference was statistically significant(P<0.01).The rate of main symptoms of emaciation(100.00%),fatigue(100.00%),cough/sputum(88.57%)and fever(88.57%)of homeless youth were significantly higher than those of general youth(18.52%,20.99%,61.73%,55.56%),the differences were statistically significant(P all<0.01).All of them in homeless youth had delayed treatment(100.00%),and 54.29%of them had delayed treatment for more than 3 months,which were significantly higher than that of general youth(8.64%),the difference was statistically significant(P<0.01).Compared with the general youth group,the white blood cell,C-reactive protein and procalcitonin levels of homeless youth were significantly increased;the hemoglobin and albumin levels were significantly decreased,and the positive rate of acid-fast bacilli in sputum smear(100.00%)was significantly increased,the differences were statistically significant(P all<0.01).The most common manifestation of chest imaging of homeless youth was multiple cavities(77.14%),which was significantly higher than that of general youth(41.98%),the difference was statistically significant(P<0.01).The proportion of pulmonary infection(74.29%),respiratory failure(40.00%),shock(22.86%)of homeless youth were also significantly higher than those of general youth(18.52%,1.23%,0.00%),the differences were statistically significant(P all<0.01).There were 10 deaths among homeless youth upon discharge,and the mortality rate(28.57%)was significantly higher than that of general youth(1.23%),with a statistically significant difference(P<0.01).Conclusion Homeless youth tuberculosis patients had a high rate of delayed treatment,serious symptoms,more complications and high mortality rate.
作者
谢平
陈彩萍
王迎迎
白茹
刘亮明
XIE Ping;CHEN Caiping;WANG Yingying;BAI Ru;LIU Liangming(Department of Infection,Shanghai Songjiang District Central Hospital,Shanghai 201600,China)
出处
《热带医学杂志》
CAS
2023年第6期842-846,共5页
Journal of Tropical Medicine
基金
上海市松江区科技攻关项目(20sjkjgg100)
关键词
流浪青年
肺结核
临床特点
Homeless youth
Pulmonary tuberculosis
Clinical characteristics
作者简介
谢平(1984-),女,硕士,副主任医师,从事结核病临床与基础研究工作;通信作者:刘亮明,E-mail:liuliangming@hotmail.com
