Lado Lado F L, Tuñez Bastida V, Golpe Gómez A L, Cabarcos Ortiz de Barrón A, Pérez del Molino M L
Servicio de Medicina Interna, Complejo Hospitalario Universitario de Santiago, C/A Choupana s/n. 15706 Santiago de Compostela, A Coruña.
An Med Interna. 2002 Mar;19(3):111-4.
To analyse the distribution of the forms of presentation of tuberculosis (TPF) in elderly patients.
The medical records of patients diagnosed with tuberculosis attending the Tuberculosis Prevention and Control Unit of the Santiago Health District were reviewed over of six years period. The classification of TPF was: pulmonary forms (P), disease confined to the lung; extrapulmonary forms (EF), disease outside the lung; mixed forms (MF), the presence of both pulmonary and extrapulmonary tuberculosis; disseminated forms (DF), the presence of two or more extrapulmonary locations; and miliary TB, which was defined by a diffuse pulmonary radiographic pattern or diagnosis was undertaken by necropsy.
A total of 278 tuberculosis infected patients were observed, 156 (56.2%) were men and 122 (43.8%) women, their mean age was 75.3 years (range 65-95). The distribution of TPF was: 155 (55.8%) P forms; 66 (23.7%) EF, of which 27 (41.0%) were ganglionary location, 12 (18.2%) bone and joint, 8 (12.0%) intestinal, 6 (9.1%) peritoneal, 5 (7.6%) meningeal, and other locations 8 (12.1%); MF 47 cases (16.9%); miliary TB 7 cases (2.5%) and. DF 3 cases (1.1%). None case was observed of HIV infected patient.
Our findings confirm high incidence of extrapulmonary TB in elderly patients. Our experience shows a modification to the classical presentation of the disease, and thus the need for sensitivity in locating the disease.
分析老年患者结核病（TPF）的表现形式分布情况。
回顾圣地亚哥健康区结核病防治单位六年期间诊断为结核病患者的病历。TPF的分类为：肺部形式（P），疾病局限于肺部；肺外形式（EF），肺部以外的疾病；混合形式（MF），同时存在肺结核和肺外结核；播散形式（DF），两个或更多肺外部位存在病变；以及粟粒性结核病，其通过弥漫性肺部放射学模式定义或通过尸检进行诊断。
共观察到278例结核病感染患者，其中男性156例（56.2%），女性122例（43.8%），平均年龄75.3岁（范围65 - 95岁）。TPF的分布情况为：155例（55.8%）为P形式；66例（23.7%）为EF，其中27例（41.0%）为淋巴结部位，12例（18.2%）为骨关节，8例（12.0%）为肠道，6例（9.1%）为腹膜，5例（7.6%）为脑膜，其他部位8例（12.1%）；MF 47例（16.9%）；粟粒性结核病7例（2.5%），DF 3例（1.1%）。未观察到HIV感染患者病例。
我们的研究结果证实老年患者肺外结核的高发病率。我们的经验表明该疾病的经典表现有所改变，因此在疾病定位方面需要提高敏感性。
