Department of Paediatrics, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Int J Tuberc Lung Dis. 2010 Feb;14(2):155-9.
A cohort of 78 adolescents was selected for evaluation with culture or histologically proven pulmonary tuberculosis (PTB) from a tertiary paediatric facility in northern Taiwan.
To assess the validity of clinical features and radiographic findings for predicting positive smears of acid-fast bacilli (AFB) in adolescents with PTB.
A retrospective descriptive study of adolescents with a confirmed diagnosis of PTB. Clinical symptoms and chest radiographs were assessed. Univariate analysis identified risk factors suggestive of a positive AFB smear, and the adjusted odds ratio (aOR) for these features was calculated using logistic regression.
Patients who were AFB smear-positive and those who were smear-negative differed significantly on univariate analysis (P < 0.05) with respect to chronic cough, haemoptysis, multilobar or superior segment of lower lobe involvement, cavitations or presence of pleural effusions. Logistic regression analysis revealed that risk factors of positive smear in adolescents with PTB were chronic cough >4 weeks (aOR 13.8, 95%CI 2.3-83.1), lower lobe involvement (aOR 12.6, 95%CI 1.2-134.8) and pulmonary cavitations (aOR 7.7, 95%CI 1.0-57.7).
For adolescents with PTB, those suffering from chronic cough for >4 weeks, with involvement of the superior segment of the lower lobe or with cavitary lesions, have a greater likelihood of transmitting tuberculosis due to smear positivity.
从台湾北部一家儿科三级医疗机构选择了 78 名患有经培养或组织学证实的肺结核（PTB）的青少年进行评估。
评估临床特征和影像学表现对预测青少年肺结核抗酸杆菌（AFB）阳性涂片的有效性。
对确诊为 PTB 的青少年进行回顾性描述性研究。评估临床症状和胸部 X 线片。单因素分析确定了提示 AFB 涂片阳性的危险因素，并使用逻辑回归计算了这些特征的调整后优势比（aOR）。
在单因素分析中，AFB 涂片阳性的患者和涂片阴性的患者在慢性咳嗽、咯血、多肺叶或下叶上叶受累、空洞或胸腔积液方面存在显著差异（P<0.05）。逻辑回归分析显示，PTB 青少年中阳性涂片的危险因素为慢性咳嗽>4 周（aOR 13.8，95%CI 2.3-83.1）、下叶受累（aOR 12.6，95%CI 1.2-134.8）和肺空洞（aOR 7.7，95%CI 1.0-57.7）。
对于患有 PTB 的青少年，那些持续>4 周慢性咳嗽、下叶上叶受累或有空洞病变的患者，由于涂片阳性，更有可能传播结核病。
