Levchuk L I, Pukhovskoĭ A G, Kisel' M A
Probl Tuberk Bolezn Legk. 2006(12):27-9.
Cases of pulmonary tuberculosis at the lower and middle lobular are not so rare. However, there is evidence that there is a rise in the number of patients with lower lobular tuberculosis (0.56-15.1%) of those with pulmonary tuberculosis. The diagnosis of lower lobular tuberculosis presents certain difficulties; it has to be differentiated from multisegmental pneumonia and tumors in some cases. Middle and lower tuberculosis was notified in 4.7% among the first detected patients in the Brest Region in 2003, in 6.8% among the patients with infiltrative pulmonary tuberculosis during 8 months in 2004. Forty-three cases of pulmonary tuberculosis at the above sites were studied in the inpatients of pulmonary tuberculosis departments of the regional tuberculosis dispensary in 2003 and during 6 months in 2004. All these patients were diagnosed as having infiltrative lower lobular tuberculosis that amounted to 5% of infiltrative pulmonary tuberculosis at all sites treated at the hospital. In most cases, there were first diagnosed patients [n = 35 (81.4%)], 8 (18.6%) patients with recurrences. There were 32 (69.8%) males and 11 (25.6%) females; 24 (55.8%) urban dwellers and 19 (44.2%) rural ones. The patients aged over 60 years were predominant [n = 21 (48.8%)], so were pensioners [n = 19 (44.2%)]. Eleven (25.6%) patients had concomitant cardiovascular diseases, 3 (7%) patients had diabetes mellitus; 1 (2.3%) patient had respiratory diseases and one more (2.3%) patient had gastrointestinal diseases; other abnormalities were observed in 11 (25.6%) patients. Most patients [n = 31 (72.1%)] were identified in those seeking medical advice; 12 (27.9%) patients were detected on prophylactic examinations. Thirty-seven (86%) patients had pulmonary and intoxication complaints of varying duration; 6 (14%) patients had no complaints. Due to the untypical acute onset of the disease, 53.5% of this group of patients were admitted to therapeutic and pulmonological departments for suspected pneumonia or other diseases. The efficiency of treatment was as follows: decay cavities were closed in 10 (66.7%) patients; 16 (69.6%) patients stopped isolating Mycobacterium tuberculosis; 7 (16.3%) patients discontinued therapy themselves.
中下叶肺结核病例并不罕见。然而，有证据表明，肺结核患者中下叶肺结核患者的数量有所上升（占肺结核患者的0.56 - 15.1%）。中下叶肺结核的诊断存在一定困难；在某些情况下，必须与多节段肺炎和肿瘤相鉴别。2003年，在布雷斯特地区首次检测出的患者中，中下叶肺结核报告率为4.7%；2004年8个月期间，浸润性肺结核患者中该报告率为6.8%。2003年和2004年6个月期间，对地区结核病防治所肺结核科住院患者中上述部位的43例肺结核病例进行了研究。所有这些患者均被诊断为浸润性中下叶肺结核，占医院治疗的所有部位浸润性肺结核的5%。大多数病例（n = 35，81.4%）为初诊患者，8例（18.6%）为复发患者。男性32例（69.8%），女性11例（25.6%）；城市居民24例（55.8%），农村居民19例（44.2%）。60岁以上患者居多（n = 21，48.8%），退休人员也居多（n = 19，44.2%）。11例（25.6%）患者伴有心血管疾病，3例（7%）患者患有糖尿病；1例（2.3%）患者患有呼吸系统疾病，1例（2.3%）患者患有胃肠道疾病；11例（25.6%）患者有其他异常情况。大多数患者（n = 31，72.1%）是在就医时被确诊的；12例（27.9%）患者是在预防性检查中被发现的。37例（86%）患者有不同病程的肺部和中毒症状；6例（14%）患者无任何症状。由于该组患者疾病急性发作不典型，53.5%的患者因疑似肺炎或其他疾病被收治到治疗科和肺病科。治疗效果如下：10例（66.7%）患者的空洞闭合；16例（69.6%）患者停止排出结核分枝杆菌；7例（16.3%）患者自行停止治疗。
