摘要
目的研究抗酸染色阳性(涂阳)和(或)结核分枝杆菌培养阳性(培阳)的肺结核患者合并肺部其他感染的相关因素分析,讨论涂阳和(或)培阳肺结核患者合并肺部其他感染的临床特点。方法采用回顾性分析方法,选择2018年6月至2019年3月于北京胸科医院住院治疗的结核菌涂阳和(或)培阳的肺结核151例,分为肺结核合并肺部感染组(感染组),肺结核不合并肺部感染组(对照组),数据统计使用SPSS 22.0软件进行统计分析,计数资料采用χ~2进行统计检验,计量资料采用独立样本T检验,以P<0.05为差异具有统计学意义。结果肺炎克雷白菌、鲍曼不动杆菌、真菌、铜绿假单胞菌、阴沟肠杆菌和产气肠杆菌是肺结核患者最易合并感染的致病菌;性别、年龄、结核菌的敏感和耐药均不是肺结核合并肺部其他感染的危险因素(P>0.05);结核病的初治和复治、罹患糖尿病是肺结核合并肺部其他感染的危险因素(P>0.05);在感染组和对照组中降钙素原无明显差异(P>0.05),而感染组的C反应蛋白值显著高于对照组(P<0.05)。结论在涂阳和(或)培阳肺结核患者中,肺结核合并糖尿病患者和复治患者更易并发肺部其他感染,C反应蛋白水平越高提示合并肺部感染的可能性越大。
Objective To study the related factors of pulmonary tuberculosis patients with positive acid-fast staining and/or positive Mycobacterium tuberculosis and other pulmonary infections, and to discuss the clinical characteristics of pulmonary tuberculosis patients with positive smear and/or positive pulmonary tuberculosis complicated with other pulmonary infections. Methods A retrospective analysis was carried out on 151 cases of tuberculosis smear positive and/or culture positive tuberculosis hospitalized in Beijing Thoracic Hospital from June 2018 to March 2019. Those patients were divided into the tuberculosis with infection group(the infection group) and the tuberculosis without infection group(the control group). The data were analyzed by SPSS 22.0 software. The counting data were tested by Chi-square test, and the measurement data were tested by independent sample T test. The difference was statistically significant with P<0.05. Results Klebsiella pneumoniae, Acinetobacter baumanii, fungi, Pseudomonas aeruginosa, Enterobacter cloacae and Enterobacter aerogenes were the most common pathogens in patients with pulmonary tuberculosis. Gender, ages, tuberculosis drug of susceptibility and resistance were not risk factors for pulmonary tuberculosis complicated with other pulmonary infection(P>0.05). Initial treatment and retreatment of tuberculosis and diabetes mellitus were risk factors for pulmonary tuberculosis complicated with other pulmonary infections(P<0.05). There was no significant difference in procalcitonin between the infection group and the control group(P>0.05), while C-reactive protein in the infection group was significant higher in the infection group than in the control group(P<0.05). Conclusion In smear positive and/or culture pulmonary tuberculosis patients, pulmonary tuberculosis patients with diabetes mellitus and retreated patients are more likely to have other pulmonary infection. The higher the level of C-reactive protein, the greater the possibility of pulmonary infection.
作者
吕子征
马丽萍
李强
刘荣梅
高孟秋
Lü Zi-zheng;MA Li-ping;LI Qiang;LIU Rong-mei;GAO Meng-qiu(Beijing Chest Hospital Affiliated to Capital Medical University,Beijing 101149,China)
出处
《临床肺科杂志》
2020年第6期888-891,共4页
Journal of Clinical Pulmonary Medicine
关键词
涂阳培阳
肺结核
肺部感染
糖尿病
smear positive and culture positive
pulmonary tuberculosis
pulmonary infection
diabetes mellitus
作者简介
通信作者:高孟秋,E-mail:gaomqwdm@aliyun.com。
