中国 28 例孕妇结核病的回顾性分析。

Retrospective Analysis of 28 Cases of Tuberculosis in Pregnant Women in China.

机构信息

Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.

Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, Beijing, China.

出版信息

Sci Rep. 2019 Oct 25;9(1):15347. doi: 10.1038/s41598-019-51695-8.

DOI:10.1038/s41598-019-51695-8

PMID:31653911

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6814810/

Abstract

While tuberculosis (TB) in pregnant women is reported globally, clinical data is unavailable in China. To describe clinical features and identify difficulties in the diagnosis of pregnancy-related TB, we performed a retrospective study of 28 TB inpatients at Beijing Chest Hospital. The results were presented in terms of interquartile range (IQR) for age, and medians and percentages with respect to the categorical variables. One patient (3.6%) was immediately diagnosed; for 27 patients (96.4%), the median interval from the initial onset of symptoms to diagnosis was five weeks. Eight cases (28.6%) were microbiologically confirmed. 22 (78.6%) were pulmonary TB (PTB), while six (21.4%) were extrapulmonary TB (EPTB). In addition, eight (28.6%) were miliary TB and six (21.4%) were cerebral TB. 27 (96.4%) were cured and one (3.6%) died. 15 neonates were identified, nine of which were healthy. Two were small for the gestational age (SGA) and one was a stillbirth. Three had neonatal TB, one of which died. Nine were legal abortions and four were spontaneous abortions. Indeed, there was a substantial delay in the diagnosis of TB in the pregnant women and a high incidence of both miliary and cerebral TB was evident. With timely treatment, prognosis is positive.

摘要

虽然全球都有报道孕妇结核病（TB）病例，但中国缺乏相关临床数据。为了描述与妊娠相关的结核病的临床特征并发现诊断难点，我们对北京胸科医院的 28 例 TB 住院患者进行了回顾性研究。结果以年龄的四分位距（IQR）、分类变量的中位数和百分比表示。1 例（3.6%）患者可立即确诊；27 例（96.4%）患者从症状初始到确诊的中位时间为 5 周。8 例（28.6%）患者的微生物学诊断得到确认。22 例（78.6%）为肺结核（PTB），6 例（21.4%）为肺外结核（EPTB）。此外，8 例（28.6%）为粟粒性结核，6 例（21.4%）为脑结核。27 例（96.4%）患者治愈，1 例（3.6%）患者死亡。共发现 15 例新生儿，其中 9 例健康。2 例为小于胎龄儿（SGA），1 例为死胎。3 例新生儿患有结核病，其中 1 例死亡。9 例为合法流产，4 例为自然流产。事实上，这些孕妇的 TB 诊断存在明显延迟，粟粒性和脑结核的发病率较高。只要及时治疗，预后通常较好。