Singh Saurabh Kumar, Tiwari Kamlesh Kumar
Department of Pulmonary Medicine, Gajra Raja Medical College and Jayarogya Group of Hospitals, Gwalior, Madhya Pradesh 474009, India.
J Trop Med. 2015;2015:230720. doi: 10.1155/2015/230720. Epub 2015 Aug 25.
Aim. To study the clinical and radiological features of lower lung field tuberculosis (LLFTB) in relation to the patients of nonlower lung field tuberculosis (non-LLFTB). Material and Methods. All the patients of lower lung field tuberculosis defined by the lesions below an arbitrary line across the hila in their chest X-rays were included in the study. Their sputum for acid fast bacilli, HIV, blood sugar, and other relevant investigations were performed. Results. The total of 2136 cases of pulmonary tuberculosis was studied. Among them 215 (10%) cases of patients were diagnosed as the case of lower lung field tuberculosis. Females (62%) were more commonly affected. Most common clinical feature in non-LLFTB was cough (69%) followed by fever (65%), chest pain (54.7%), and weight loss (54.4%). Chest X-ray showed predominance of right side (60.9%) in cases of LLFTB. The relative risk of having the LLFTB in diabetes patients, HIV seropositive patients, end stage renal disease patients, and patients on corticosteroid therapy was high. Conclusion. Lower lung field tuberculosis is not an uncommon entity. It is more common in diabetes, HIV positive, end stage renal disease, and corticosteroid treated patients. Clinical and radiological features are different from upper lobe tuberculosis patients.
目的。研究下肺野结核(LLFTB)相对于非下肺野结核(non-LLFTB)患者的临床和放射学特征。材料与方法。纳入所有胸部X线片上病变位于横跨肺门的任意一条线以下所定义的下肺野结核患者。对其进行痰涂片抗酸杆菌、HIV、血糖及其他相关检查。结果。共研究了2136例肺结核病例。其中215例(10%)被诊断为下肺野结核病例。女性(62%)更易受累。非下肺野结核最常见的临床特征是咳嗽(69%),其次是发热(65%)、胸痛(54.7%)和体重减轻(54.4%)。胸部X线显示下肺野结核病例右侧为主(60.9%)。糖尿病患者、HIV血清学阳性患者、终末期肾病患者和接受糖皮质激素治疗的患者患下肺野结核的相对风险较高。结论。下肺野结核并非罕见疾病。在糖尿病、HIV阳性、终末期肾病和接受糖皮质激素治疗的患者中更为常见。其临床和放射学特征与上叶结核患者不同。