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老年结核病的临床特征和治疗结局:一项病例对照研究。

Clinical characteristics and treatment outcomes of tuberculosis in the elderly: a case control study.

机构信息

Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea.

出版信息

BMC Infect Dis. 2013 Mar 5;13:121. doi: 10.1186/1471-2334-13-121.

Abstract

BACKGROUND

The purpose of this study was to evaluate the differences in clinical characteristics and treatment outcomes between older and younger tuberculosis (TB) patients in Korea.

METHODS

We retrospectively analyzed the medical records of 271 younger (20-64 years old at diagnosis) and 199 older (≥65 years) TB patients who had been newly diagnosed and treated at Chonnam National University Hospital from May 2008 to August 2010.

RESULTS

Dyspnea and comorbid medical conditions were more frequent and positive TB culture rates were higher in older TB patients. In chest computed tomography (CT) scans of pulmonary TB patients, older patients were less likely to have micronodules (<7 mm in diameter), nodules (<30 mm in diameter), masses (>30 mm in diameter), and cavities compared with younger patients, but were more likely to have consolidations. Incidence of adverse drug reactions did not differ between the two groups, except for severe gastrointestinal disorders. There were no significant differences in favorable treatment outcomes between younger and older TB patients (97% vs. 94%, respectively; p = 0.251).

CONCLUSIONS

Older TB patients had more frequent dyspnea and less frequent active TB findings on chest CT. Treatment success and adverse drug reaction rates were similar in older and younger TB patients.

摘要

背景

本研究旨在评估韩国老年和年轻结核病(TB)患者的临床特征和治疗结局差异。

方法

我们回顾性分析了 2008 年 5 月至 2010 年 8 月在全南国立大学医院新诊断和治疗的 271 名年轻(诊断时 20-64 岁)和 199 名老年(≥65 岁)TB 患者的病历。

结果

老年 TB 患者呼吸困难和合并症更为常见,结核分枝杆菌阳性培养率更高。在肺结核患者的胸部计算机断层扫描(CT)中,与年轻患者相比,老年患者更不可能出现微结节(直径<7 毫米)、结节(直径<30 毫米)、肿块(直径>30 毫米)和空洞,但更可能出现实变。除严重胃肠道疾病外,两组不良反应发生率无差异。年轻和老年 TB 患者的治疗结局无显著差异(分别为 97%和 94%;p=0.251)。

结论

老年 TB 患者呼吸困难更为频繁,胸部 CT 上活动性结核表现更为少见。老年和年轻 TB 患者的治疗成功率和药物不良反应发生率相似。

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