低发病率国家中具有高移民人口的胸膜结核的流行病学和诊断：一项回顾性研究。

Epidemiology and diagnosis of pleural tuberculosis in a low incidence country with high rate of immigrant population: A retrospective study.

机构信息

Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain.

Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain; Grupo de Estudio de Infecciones por Micobacterias, Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica, Madrid, Spain.

出版信息

Int J Infect Dis. 2019 Jan;78:34-38. doi: 10.1016/j.ijid.2018.10.005. Epub 2018 Oct 25.

DOI:10.1016/j.ijid.2018.10.005

PMID:30449728

Abstract

BACKGROUND

The confirmatory diagnosis of pleural tuberculosis (pTB) remains challenging. The aim of this study was to describe the clinical and epidemiological characteristics of pTB patients and assess the yield of different diagnostic procedures in a low burden country with a high rate of immigrant population.

METHODS

All adult patients with pTB between 2007 and 2014 were studied retrospectively.

RESULTS

One hundred and three out of 843 patients with tuberculosis had pTB. Fifty-three (54.1%) were male, and the median age was 45years (range 18-87years). Fifty-two (50.49%) patients were immigrants. A confirmed diagnosis was reached in 16 patients (15.5%) by microbiological studies of pleural effusion. Lung involvement was demonstrated by sputum smear microscopy in 13/49 (26.5%), sputum GeneXpert MTB/RIF test in 13/20 (65%), and sputum culture in 16/37 (43.2%). High-resolution computed tomography (CT) showed lung involvement in 47.7% of the patients. The cure rate was 91.3% at the 1-year follow-up. Three patients died, all of them within the first month after diagnosis.

CONCLUSIONS

The detection of lung involvement increased by two-fold when lung CT was used; this correlated with the likelihood of finding a positive microbiological result on sputum sample testing. Pleural microbiological studies had a low diagnostic yield, and sputum could have a complementary role.

摘要

背景

胸膜结核（pTB）的确诊仍然具有挑战性。本研究的目的是描述低负担国家中具有高移民人口比例的胸膜结核患者的临床和流行病学特征，并评估不同诊断程序的效果。

方法

回顾性研究了 2007 年至 2014 年间所有患有胸膜结核的成年患者。

结果

843 例结核病患者中有 103 例患有胸膜结核。53 例（54.1%）为男性，中位年龄为 45 岁（范围 18-87 岁）。52 例（50.49%）为移民。16 例（15.5%）患者通过胸腔积液微生物学研究确诊。49 例患者中，13 例（26.5%）通过痰涂片显微镜检查发现肺部受累，20 例患者中 13 例（65%）通过痰 GeneXpert MTB/RIF 检测发现肺部受累，37 例患者中 16 例（43.2%）通过痰培养发现肺部受累。高分辨率计算机断层扫描（CT）显示 47.7%的患者肺部受累。1 年随访时治愈率为 91.3%。3 例患者死亡，均在诊断后第一个月内死亡。