Spencer D, Yagan R, Blinkhorn R, Spagnuolo P J
Department of Medicine, Case Western Reserve University School of Medicine, Metropolitan General Hospital, Cleveland 44109.
Chest. 1990 Feb;97(2):384-8. doi: 10.1378/chest.97.2.384.
Nine patients with pulmonary tuberculosis involving predominantly or exclusively the anterior segment of one or both upper lobes were seen over a five-year period. The incidence of anterior segment upper lobe tuberculosis was 6.3 percent of 142 patients presenting with pulmonary tuberculosis during the same time period. Five of the nine patients with anterior segment upper lobe involvement had reactivation disease. An increased incidence of advanced age, diabetes, associated malignant neoplasms, alcoholism, and steroid use were noted in those patients with anterior segment involvement, although only the occurrence of diabetes was statistically significant. We suggest vigilance with regard to the diagnosis of tuberculosis in patients who are elderly, diabetic, or alcohol abusers, particularly where the roentgenographic appearance of anterior segment upper lobe involvement would tend to favor an alternative diagnosis.
在五年期间共诊治了9例主要或仅累及一侧或双侧上叶前段的肺结核患者。同期142例肺结核患者中，上叶前段肺结核的发病率为6.3%。9例上叶前段受累患者中有5例为复发性疾病。上叶前段受累患者中，高龄、糖尿病、合并恶性肿瘤、酗酒和使用类固醇的发生率增加，尽管只有糖尿病的发生具有统计学意义。我们建议，对于老年、糖尿病或酗酒患者，在诊断结核病时应保持警惕，特别是当影像学表现为上叶前段受累时，可能倾向于其他诊断。
