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评价儿童肺结核和肺外结核的临床和实验室特征。

Evaluation of Clinical and Laboratory Characteristics of Children with Pulmonary and Extrapulmonary Tuberculosis.

机构信息

Department of Pediatric Infectious Disease, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, 34303 Istanbul, Turkey.

出版信息

Medicina (Kaunas). 2019 Aug 1;55(8):428. doi: 10.3390/medicina55080428.

Abstract

: Tuberculosis (TB) is an important public health problem in both developing and developed countries. Childhood TB is also an important epidemiological indicator in terms of forming the future TB pool. The diagnosis of TB is difficult in children due to the lack of a standard clinical and radiological description. We aimed to evaluate and compare the clinical, laboratory, and radiologic findings of childhood pulmonary and extrapulmonary TB. The medical records of patients hospitalized with the diagnosis of pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB) between December 2007 and December 2017 were evaluated retrospectively. : There were 163 patients diagnosed with TB with 94 females (57.7%) and 69 males (42.3%). Seventy-three patients (44.8%) had PTB, 71 (43.6%) patients had EPTB, and 19 patients (11.7%) had both PTB and EPTB, called as disseminated TB. Ninety-six (58.9%) patients had tuberculin skin test (TST) positivity and 64 patients (39.3%) had interferon-gamma release assay (IGRA) positivity. Acid-resistant bacteria were observed in 34 (20.9%) body fluid samples and culture positivity was observed in 33 (20.2%) samples. Comparison of PTB, EPTB, and disseminated TB revealed that low socioeconomic status, TB contact, and low body weight were more common in disseminated TB, and TST positivity was more common in PTB. : Malnutrition, low socioeconomic status, and TB contact were important diagnostic variables in our study and all three parameters were more common in disseminated TB. Tuberculosis should be considered in patients admitted with different complaints and signs in populations with high TB incidence and low socioeconomic status.

摘要

结核病(TB)是发展中国家和发达国家都面临的重要公共卫生问题。儿童结核病也是未来结核池形成的一个重要流行病学指标。由于缺乏标准的临床和影像学描述,儿童结核病的诊断较为困难。我们旨在评估和比较儿童肺部和肺外结核病的临床、实验室和影像学表现。

回顾性分析了 2007 年 12 月至 2017 年 12 月期间因肺结核(PTB)和肺外结核(EPTB)住院的患者的病历。

共有 163 例患者被诊断为结核病,其中 94 例为女性(57.7%),69 例为男性(42.3%)。73 例(44.8%)为肺结核,71 例(43.6%)为肺外结核,19 例(11.7%)同时患有肺结核和肺外结核,称为播散性结核。96 例(58.9%)患者结核菌素皮肤试验(TST)阳性,64 例(39.3%)患者干扰素-γ释放试验(IGRA)阳性。34 例(20.9%)体液样本中发现抗酸杆菌,33 例(20.2%)样本培养阳性。PTB、EPTB 和播散性 TB 的比较表明,在播散性 TB 中,社会经济地位低、TB 接触和低体重更为常见,TST 阳性更为常见。

在我们的研究中,营养不良、社会经济地位低和 TB 接触是重要的诊断变量,这三个参数在播散性 TB 中更为常见。在结核病发病率高、社会经济地位低的人群中,对于有不同症状和体征的患者,都应考虑到结核病的可能。

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