Lee Ki Man, Choe Kang Hyeon, Kim Sung Jin
Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
Korean J Intern Med. 2006 Dec;21(4):230-5. doi: 10.3904/kjim.2006.21.4.230.
[corrected] The radiographic characteristics of tuberculous pneumonia in adults are similar to primary tuberculosis that occurs in childhood, and upper lobe cavitary tuberculosis is the hallmark of postprimary tuberculosis. The purpose of this study was to investigate the factors associated with tuberculous pneumonia by making comparison with cavitary tuberculosis.
The medical records and radiographic findings of patients with cavitary tuberculosis and tuberculous pneumonia, and who were diagnosed between March 2003 and February 2006, were analyzed retrospectively.
Forty patients had cavitary tuberculosis and sixteen patients had tuberculous pneumonia. Fever was more frequent for tuberculous pneumonia, whereas hemoptysis was more frequent for cavitary tuberculosis. The duration of symptoms before visiting the hospital was shorter, but the diagnosis after admission was more delayed for tuberculous pneumonia patients than for cavitary tuberculosis patients. The prevalence of underlying comorbidities such cancer, diabetes, alcoholism and long-term steroid use was not different between the two groups. The patients with tuberculous pneumonia were older and they had lower levels of serum albumin and hemoglobin than those with cavitary tuberculosis. The patients with tuberculous pneumonia showed a tendency to have more frequent endobronchial lesion. Tuberculous pneumonia occurred in any lobe, whereas the majority of cavitary tuberculosis patients had upper lung lesion, but the prevalence of lymphadenopathy, pleural effusion and previous tuberculosis scar was not different between the two groups.
Older age, a lower level of serum albumin and hemoglobin and a random distribution of lesion were associated with tuberculosis pneumonia as compared with cavitary tuberculosis. These findings suggest that the pathogenesis of tuberculous pneumonia might be different from that of cavitary tuberculosis.
[已修正] 成人结核性肺炎的影像学特征与儿童原发性肺结核相似，而上叶空洞性肺结核是继发性肺结核的标志。本研究的目的是通过与空洞性肺结核进行比较，调查与结核性肺炎相关的因素。
回顾性分析2003年3月至2006年2月期间诊断为空洞性肺结核和结核性肺炎患者的病历及影像学检查结果。
40例患者有空洞性肺结核，16例患者有结核性肺炎。结核性肺炎发热更常见，而空洞性肺结核咯血更常见。结核性肺炎患者就诊前症状持续时间较短，但入院后诊断比空洞性肺结核患者更延迟。两组患者癌症、糖尿病、酗酒和长期使用类固醇等基础合并症的患病率无差异。结核性肺炎患者年龄较大，血清白蛋白和血红蛋白水平低于空洞性肺结核患者。结核性肺炎患者支气管内病变更常见。结核性肺炎可发生于任何肺叶，而大多数空洞性肺结核患者有上肺病变，但两组患者淋巴结肿大、胸腔积液和既往结核瘢痕的患病率无差异。
与空洞性肺结核相比，年龄较大、血清白蛋白和血红蛋白水平较低以及病变随机分布与结核性肺炎有关。这些发现表明结核性肺炎的发病机制可能与空洞性肺结核不同。
