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尘肺病和肝硬化不是肺部感染患者患肺结核的危险因素。

Pneumoconiosis and liver cirrhosis are not risk factors for tuberculosis in patients with pulmonary infection.

作者信息

Wu Huang-Pin, Pan Yu-Huei, Hua Chung-Ching, Shieh Wen-Bin, Jiang Bor-Yiing, Yu Teng-Jen

机构信息

Division of Pulmonary Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Keelung, Taiwan.

出版信息

Respirology. 2007 May;12(3):416-9. doi: 10.1111/j.1440-1843.2007.01033.x.

Abstract

BACKGROUND AND OBJECTIVE

It is unclear whether patients with liver cirrhosis and coal miners with pneumoconiosis are at increased risk of developing pulmonary tuberculosis (TB). Furthermore, little is known of the likelihood of pneumonia in patients with bronchiectasis, haemodialysis, diabetes mellitus or advanced lung cancer being due to TB. To answer these questions, patients with these clinical comorbidities were analysed.

METHODS

The study was retrospective and included 264 TB patients, 478 non-TB pneumonia patients, and as negative controls, 438 subjects without pneumonia. The parameters analysed were age, gender and the presence of pneumoconiosis, bronchiectasis, liver cirrhosis, haemodialysis, diabetes mellitus and advanced lung cancer.

RESULTS

Male gender was the only significant factor increasing the risk of pulmonary TB. When compared with non-TB pneumonia and control patients, the odds ratios were 1.862 and 2.182, respectively. Patients with liver cirrhosis did not show an increased risk of pulmonary TB after regression analysis. Pneumoconiosis resulted in a 2.260 (P = 0.003) odds ratio for pulmonary TB, compared with the controls. However, there was no difference in pneumoconiosis between TB and non-TB pneumonia patients. Patients with bronchiectasis, lung cancer and those receiving haemodialysis had a lower risk for pulmonary TB in lower respiratory tract infection, with odds ratios of 0.342, 0.311 and 0.182, respectively.

CONCLUSION

Physicians should first consider non-TB bacterial infection rather than Mycobacterium tuberculosis infection in pneumonia in patients with bronchiectasis, lung cancer or those receiving haemodialysis.

摘要

背景与目的

目前尚不清楚肝硬化患者和尘肺病煤矿工人患肺结核(TB)的风险是否增加。此外,对于支气管扩张、血液透析、糖尿病或晚期肺癌患者发生肺炎由TB引起的可能性知之甚少。为回答这些问题,对患有这些临床合并症的患者进行了分析。

方法

本研究为回顾性研究,纳入了264例TB患者、478例非TB肺炎患者,以及438例无肺炎的受试者作为阴性对照。分析的参数包括年龄、性别以及尘肺病、支气管扩张、肝硬化、血液透析、糖尿病和晚期肺癌的存在情况。

结果

男性是增加肺结核风险的唯一显著因素。与非TB肺炎患者和对照患者相比,优势比分别为1.862和2.182。回归分析后,肝硬化患者未显示出患肺结核的风险增加。与对照组相比,尘肺病导致肺结核的优势比为2.260(P = 0.003)。然而,TB患者和非TB肺炎患者之间的尘肺病情况没有差异。支气管扩张、肺癌患者和接受血液透析的患者在下呼吸道感染中患肺结核的风险较低,优势比分别为0.342、0.311和0.182。

结论

对于支气管扩张、肺癌患者或接受血液透析的患者发生的肺炎,医生应首先考虑非TB细菌感染而非结核分枝杆菌感染。

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