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目的探讨菌阴肺结核与菌阳肺结核在临床的表现特点。方法收集同期初治菌阴65例和菌阳58例活动性肺结核患者临床资料,并进行回顾性分析。结果菌阳组卫生系统延迟、诊断延迟及首诊延迟的发生率分别为67.2%、87.9%和34.5%,稍高于菌阴组的64.6%、76.9%和29.2%,两组卫生系统延迟及诊断延迟的发生率均较高,但差异无统计学意义(P>0.05)。菌阳组血清腺苷脱氨酶(adenosine deaminase,ADA)升高率、血沉增快率和血常规异常分别为25.9%、79.3%和27.6%,高于菌阴组的4.6%、41.5%和6.2%,差异有统计学意义(P<0.05)。菌阳组双侧肺叶和3个肺野以上的受累率分别为56.9%和37.9%,高于菌阴组的38.5%和9.2%,差异均有统计学意义(P<0.05)。菌阳组合并糖尿病发生率为34.5%,高于菌阴组的10.8%,差异有统计学意义(P<0.05)。结论菌阳肺结核患者肺叶受累较菌阴肺结核明显,血液检验指标异常比例高。菌阴肺结核的临床正确诊断有一定困难。
Objective To investigate the clinical features of bacterial yin pulmonary tuberculosis and bacillary positive pulmonary tuberculosis. Methods The clinical data of 65 patients with active bacteria and 58 patients with active pulmonary tuberculosis at the beginning of the same period were collected and analyzed retrospectively. Results The incidence of delay, diagnosis delay and first visit delay in hygiene system of bacteria positive group were 67.2%, 87.9% and 34.5% respectively, slightly higher than 64.6%, 76.9% and 29.2% in bacterial negative group. Delay of the two health systems and The incidence of delayed diagnosis was higher, but the difference was not statistically significant (P> 0.05). The positive rates of adenosine deaminase (ADA), erythrocyte sedimentation rate and blood abnormalities were 25.9%, 79.3% and 27.6%, respectively, which were higher than 4.6% and 41.5% respectively 6.2%, the difference was statistically significant (P <0.05). The positive rates of bilateral lung lobes and three lung fields in bacillary positive group were 56.9% and 37.9%, respectively, which were higher than those in bacterial negative group (38.5% and 9.2%, P <0.05). The prevalence of bacilli combined with diabetes mellitus was 34.5%, which was higher than that of bacteria negative group (10.8%), the difference was statistically significant (P <0.05). Conclusion Bacterial pulmonary tuberculosis patients with pulmonary involvement than obvious pulmonary tuberculosis, abnormal blood test indicators high. Clinical diagnosis of negative pulmonary tuberculosis have some difficulties.