中国西南地区成人与儿童气管支气管结核患者的流行病学和临床特征差异。
Differences in epidemiological and clinical features between adult and pediatric tracheobronchial tuberculosis patients in Southwest China.
机构信息
Department of Tuberculosis, Public Health Clinical Center of Chengdu, Chengdu, China.
Department of Thoracic Surgery, Public Health Clinical Center of Chengdu, Chengdu, China.
出版信息
Front Public Health. 2023 Jul 19;11:1225267. doi: 10.3389/fpubh.2023.1225267. eCollection 2023.
BACKGROUND
Tracheobronchial tuberculosis (TBTB) is a common form of extrapulmonary tuberculosis that affects the tracheobronchial tree. However, the mechanism has not been fully elucidated. Comparisons of clinical characteristics in various age groups can aid in the understanding of TBTB.
METHODS
This retrospective study was conducted at the Public Health Clinical Center of Chengdu between July 2017 and December 2021, including adults and children with TBTB. Clinical data were extracted from medical records. T/T' test, Mann-Whitney U test, Chi-square test, or Fisher's exact test were used in this study.
RESULTS
This study enrolled 347 patients with TBTB (175 adults and 172 children). Adult females were more susceptible to TBTB, whereas gender-based differences were not observed in children. Children had a higher occurrence of irritant dry cough and fever, and acute hematogenous disseminated PTB, and specific types of EPTB, but a shorter interval before diagnosis, and lower diagnostic yields compared to adults ( < 0.05). Adults presented more extensive lung lesions and cavitations as compared to children. Granulation hyperplasia and lymph fistula were more frequently observed in children, as well as airway stenosis, but less severe.
CONCLUSIONS
The study revealed important variations exist in multiple respects between adults and children with TBTB.
背景
气管支气管结核（TBTB）是一种常见的肺外结核形式，影响气管支气管树。然而，其机制尚未完全阐明。比较不同年龄段的临床特征有助于了解 TBTB。
方法
本回顾性研究于 2017 年 7 月至 2021 年 12 月在成都公共卫生临床医疗中心进行，纳入 TBTB 的成人和儿童患者。从病历中提取临床数据。本研究采用 T/T'检验、Mann-Whitney U 检验、卡方检验或 Fisher 确切概率法。
结果
本研究纳入 347 例 TBTB 患者（成人 175 例，儿童 172 例）。成人女性更容易患 TBTB，而儿童则无性别差异。儿童更常出现刺激性干咳和发热，以及急性血行播散性肺结核和特定类型的结核性胸膜炎，但诊断前的间隔时间更短，诊断率低于成人（<0.05）。与儿童相比，成人的肺部病变和空洞更广泛。与成人相比，儿童更常出现肉芽组织增生和淋巴管瘘，以及气道狭窄，但程度较轻。
结论
本研究揭示了成人和儿童 TBTB 在多个方面存在重要差异。
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