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目的探讨老年慢性阻塞性肺病合并肺结核的临床特点及治疗措施。方法回顾分析自2005年5月至2009年12月间,共收住老年COPD合并结核患者160例的临床资料。结果在积极抗结核治疗及抗炎、对症、支持、免疫治疗下,本组患者中除15例抗感染治疗无效发生痰窒息和呼吸衰竭、心力衰蝎死亡,其余患者在肺结核好转同时,肺部感染均好转。结论老年合并COPD患者由于常年慢性咳嗽、咯痰、气喘,当并发结核感染时,缺乏结核典型症状,早期临床上常被原发病掩盖,致使诊断被延误,导致误诊。内科医师应提高警惕,在不能明确是否合并结核病的情况下,应慎用或禁用激素,以防结核病恶化播散。
Objective To investigate the clinical features and treatment of senile chronic obstructive pulmonary disease complicated with pulmonary tuberculosis. Methods Retrospective analysis from May 2005 to December 2009, a total of elderly patients with COPD admitted to the clinical data of 160 cases of tuberculosis. Results In the active anti-TB treatment and anti-inflammatory, symptomatic, supportive, immunotherapy, sputum asphyxia and respiratory failure were not found in 15 patients in this group. Heart failure scorpion was dead. In the other patients, Infections were all better. Conclusions Elderly patients with COPD usually have chronic cough, expectoration and asthma due to chronic perennial cough, sputum and asthma. When they have complicated tuberculosis infection, the elderly patients with COPD often lack the typical symptoms of tuberculosis and are often obscured by the primary disease in early clinical stage, resulting in the delay of diagnosis and misdiagnosis. Physicians should be vigilant, in the case can not be clear whether the merger of tuberculosis should be cautious or disabled hormones to prevent the spread of tuberculosis worsened.