菌阳结核病患者1494例临床分析

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目的分析1494例结核菌培养阳性结核病患者临床资料,为结核病的预防和控制提供参考依据。方法收集2012年1月-2015年12月遵义医学院附属医院门诊和住院所有4486例送检结核菌培养患者中确诊的1494例菌阳结核病患者临床病例资料进行分析。结果 1494例菌阳结核病患者中,男性占59.6%,女性占40.4%;≤18岁占8.9%,19~35岁占20.6%,36~60岁占36.1%、>60岁占34.4%;居住在城镇占42.8%,农村占57.2%。送检的标本中痰液、支气管镜刷检物或灌洗液、经皮肺穿刺物、尿液、创面分泌物及脓肿/包块/淋巴结穿刺物、心包积液、脑脊液、腹水、胸膜组织和胸水的阳性检出率分别为42.2%、46.3%、47.6%、24.3%、37.2%、33.3%、20.1%、8.7%、26.2%、9.6%,总阳性检出率为33.3%。1 494例菌阳结核病患者中,初治者占77.9%,复治者占22.1%;不同特征菌阳结核病患者比较,不同性别、年龄和居住地菌阳结核病患者初治复治分布差异均有统计学意义(均P<0.01);初治者中耐多药患者占0.52%,低于复治者中的12.12%,差异有统计学意义(X~2=116.05,P<0.01)。结论菌阳结核病患者男性多于女性,中老年患者高于中青年患者,农村高于城镇;初治结核病患者较复治患者多,复治患者耐多药比例较初治患者高。 Objective To analyze the clinical data of 1494 tuberculosis-positive TB patients and provide a reference for the prevention and control of tuberculosis. Methods The data of 1494 cases of bacillary positive pulmonary tuberculosis diagnosed in 4486 outpatients and inpatients admitted to TB hospital affiliated to Zunyi Medical College from January 2012 to December 2015 were analyzed. Results Among 1494 cases of bacillary tuberculosis patients, male accounted for 59.6% and female accounted for 40.4%; patients aged ≤18 years accounted for 20%, 19 ~ 35 years old accounted for 20.6%, 36 ~ 60 years old accounted for 36.1%, those aged> 60 accounted for 34.4% 42.8% in urban areas and 57.2% in rural areas. Sputum, bronchoscopy brush samples or perfusion fluid, percutaneous pulmonary puncture, urine, wound secretions and abscesses / mass / lymph node puncture, pericardial effusion, cerebrospinal fluid, ascites, pleural tissue The positive detection rate was 42.2%, 46.3%, 47.6%, 24.3%, 37.2%, 33.3%, 20.1%, 8.7%, 26.2% and 9.6% respectively, and the positive rate was 33.3%. 1 494 cases of tuberculosis patients with tuberculosis, 77.9% of newly diagnosed, retreatment accounted for 22.1%; different characteristics of positive tuberculosis patients, different sex, age and living bacteria tuberculosis patients with initial remission treatment differences were (All P <0.01). The rate of multidrug resistance in the newly diagnosed patients was 0.52%, which was lower than that of the retreated patients (12.12%). There was significant difference (X ~ 2 = 116.05, P <0.01). Conclusions There are more men than women in bacillary positive pulmonary tuberculosis patients, middle-aged and elderly patients are higher than middle-aged patients and rural areas are higher than those in urban areas. Patients with newly diagnosed tuberculosis have more MDR-refractory patients than those with newly diagnosed TB patients.
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