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目的探讨老年血型播散性肺结核临床特点。方法对90例老年血行播散性肺结核患者临床资料进行回顾性分析。结果 40%以上(38例)的患者患有基础性疾病,临床表现多样化,症状不典型;痰涂片查抗酸杆菌及PPD试验阳性率均偏低,分别为33.3%(29例)和63.3%(57例);胸部X线表现不典型,粟粒结节呈“三均匀”征象者只有7例(7.8%);延迟或延误诊断64.4%(58例)。结论各级临床医生均应提高对老年血行播散性肺结核的警惕性,对不明原因的发热、体重下降、厌食、咳嗽等,尤其是长期营养不良、糖尿病、矽肺及长期应用激素或免疫抑制剂者应考虑本病的诊断,并及时行相关检查,以便及时确诊。
Objective To investigate the clinical features of disseminated pulmonary tuberculosis in elderly patients. Methods The clinical data of 90 elderly patients with disseminated pulmonary tuberculosis were retrospectively analyzed. Results More than 40% of the patients (38 cases) had underlying diseases with diversified clinical manifestations and atypical symptoms. The positive rates of sputum smear-positive bacilli and PPD test were all low (33.3%, 29 cases) and 63.3% (57 cases). The X-ray findings of the chest were not typical. Only 7 cases (7.8%) showed miliary nodules with signs of “three uniform” and 64.4% (58 cases) with delayed or delayed diagnosis. Conclusions Clinicians at all levels should increase their vigilance against elderly hematogenous disseminated tuberculosis. They should also pay attention to unexplained fever, weight loss, anorexia and cough, especially chronic malnutrition, diabetes mellitus, silicosis and long-term use of hormones or immunosuppressants Should consider the diagnosis of the disease, and timely relevant inspection, in order to timely diagnosis.