Güler M, Unsal E, Dursun B, Aydln O, Capan N
Department of Chest Diseases, Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey.
Int J Clin Pract. 2007 Feb;61(2):231-5. doi: 10.1111/j.1742-1241.2006.01131.x.
Sputum smear and culture conversion are important indicators for the effectiveness of treatment and the infectivity of the patient. The aim of this study was to identify the factors influencing both sputum smear and culture conversion time among patients with new case pulmonary tuberculosis (TB). The study was conducted in a reference hospital in Turkey in which 737 patients with pulmonary TB were hospitalised between January 2000 and 2005. We evaluated 306 (193 men and 113 women) human immunodeficiency virus-negative patients diagnosed with new case pulmonary TB. Factors associated with both sputum smear and culture conversion time (days) were investigated. Patients with diabetes mellitus (DM), cavitary disease, radiologically extensive disease had longer sputum smear and culture conversion time than the other groups. In addition, old age, male sex, smoking and thrombocytosis were found to be significantly associated with sputum smear conversion time. In the logistic regression analysis, the presence of DM and extensive disease were determined as independent factors associated with persistent sputum smear and culture positivity at the end of 2 months. The presence of DM and extensive disease were found to be independent risk factors influencing both sputum smear and culture conversion time in pulmonary TB. Sputum smear and culture examinations should be considered together to assess the poor prognosis.
痰涂片和培养转阴是治疗效果及患者传染性的重要指标。本研究旨在确定影响初治肺结核患者痰涂片和培养转阴时间的因素。该研究在土耳其一家参考医院开展，2000年1月至2005年期间有737例肺结核患者住院。我们评估了306例（193例男性和113例女性）确诊为初治肺结核的人类免疫缺陷病毒阴性患者。对与痰涂片和培养转阴时间（天数）相关的因素进行了调查。糖尿病（DM）患者、有空洞病变者、放射学表现为广泛病变者的痰涂片和培养转阴时间比其他组更长。此外，发现高龄、男性、吸烟和血小板增多症与痰涂片转阴时间显著相关。在逻辑回归分析中，DM的存在和广泛病变被确定为与2个月末痰涂片和培养持续阳性相关的独立因素。DM的存在和广泛病变被发现是影响肺结核患者痰涂片和培养转阴时间的独立危险因素。应综合考虑痰涂片和培养检查以评估预后不良情况。
