Umeki S
Department of Medicine, Kawasaki Medical School, Okayama, Japan.
Respiration. 1989;55(2):75-83. doi: 10.1159/000195709.
A comparison of the clinical features, predisposing factors, drug-induced adverse effects and diagnostic approach in pulmonary tuberculosis in 37 younger and 35 elderly men was carried out. Elderly patients had a higher number of underlying diseases, including cardiovascular diseases and hypertension, than younger patients. The classic symptoms and signs of tuberculosis, such as productive cough, fever and general fatigue, were observed in relatively high proportions of both patients, whereas weight loss (43 vs. 16%) and crackles in the lung fields (49 vs. 16%) were significantly higher in the elderly patients than the younger ones. As for roentgenographic abnormalities, a higher involvement of middle and lower lung fields was seen in the elderly patients than in the younger. Although leukocytosis was noted in a significantly lower proportion of the elderly patients, neutropenia due to drug treatment was significantly higher (23%) than in younger patients (5%). In a mass survey, the detection of pulmonary tuberculosis in elderly men was significantly lower (23%) than that in younger men (54%), suggesting that an extensive mass survey for pulmonary tuberculosis in elderly men should be done.
对37名年轻男性和35名老年男性肺结核的临床特征、诱发因素、药物不良反应及诊断方法进行了比较。老年患者的基础疾病数量较多，包括心血管疾病和高血压，比年轻患者多。两组患者中，肺结核的典型症状和体征，如咳痰、发热和全身乏力，出现比例都相对较高，而老年患者体重减轻（43%对16%）和肺部啰音（49%对16%）的比例显著高于年轻患者。在影像学异常方面，老年患者中、下肺野受累程度高于年轻患者。虽然老年患者白细胞增多的比例显著较低，但药物治疗导致的中性粒细胞减少症显著高于年轻患者（23%对5%）。在大规模调查中，老年男性肺结核的检出率显著低于年轻男性（23%对54%），提示应对老年男性进行广泛的肺结核大规模筛查。
