Wiwatworapan Tawatchai, Anantasetagoon Tanakorn
Chest Unit, Department of Internal Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand.
Southeast Asian J Trop Med Public Health. 2008 May;39(3):521-5.
The purpose of this study was to analyze the cases of extra-pulmonary tuberculosis (EPTB) at Maharat Nakhon Ratchasima Hospital, a tertiary care regional hospital in Northeast Thailand. There were 398 cases of EPTB (46.9%) and 450 cases of pulmonary tuberculosis (PTB) (53.1%). The mean age of EPTB patients (47.58 years) was lower than that of PTB patients (51.6 years) (p < 0.01). Human Immunodeficiency Virus (HIV) seropositivity was found in 50 cases of EPTB (12.6%) and 55 cases of PTB (12.2%) which was not significantly different. The common sites of extra-pulmonary involvement were the lymph nodes (29.7%), followed by the pleura (27.4%), the bones and spine (25.1%), the meninges and brain (4.5%), the pericardium (3.5%) and the gastrointestinal tract (3.0%). Disseminated TB occurred in only 8 cases (2.0%). HIV seropositivity rates were more common in disseminated TB (OR 41.51, 95% CI 4.98-34.5), TB of the meninges and brain (OR 4.47, 95% CI 1.57-12.6) and TB of the lymph nodes (OR 3.49, 95% CI 1.86-6.54) and were less common in TB of the bones and spine (OR 0.05, 95% CI 0.01-0.37) and TB of the pleura (OR 0.24, 95%CI 0.09-0.63).
本研究旨在分析泰国东北部一家三级区域转诊医院——玛哈叻呵叻医院的肺外结核(EPTB)病例。该医院有398例肺外结核病例(占46.9%)和450例肺结核(PTB)病例(占53.1%)。肺外结核患者的平均年龄(47.58岁)低于肺结核患者(51.6岁)(p<0.01)。在50例肺外结核病例(12.6%)和55例肺结核病例(12.2%)中发现人类免疫缺陷病毒(HIV)血清学阳性,两者无显著差异。肺外受累的常见部位为淋巴结(29.7%),其次是胸膜(27.4%)、骨骼和脊柱(25.1%)、脑膜和脑(4.5%)、心包(3.5%)以及胃肠道(3.0%)。播散性结核病仅8例(占2.0%)。HIV血清学阳性率在播散性结核病(比值比41.51,95%置信区间4.98 - 34.5)、脑膜和脑结核病(比值比4.47,95%置信区间1.57 - 12.6)以及淋巴结结核病(比值比3.49,95%置信区间1.86 - 6.54)中更为常见,而在骨骼和脊柱结核病(比值比0.05,95%置信区间0.01 - 0.37)和胸膜结核病(比值比0.24,95%置信区间0.09 - 0.63)中较少见。