Shen Min, Luo Wen, Luobu Banjiu, Chen Yirong, Zhang Peiyan, Qiu Ruisi, Chen Xuerong, Guo Weiping, Chen Peifen
Department of Respiratory Medicine, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital, Shenzhen, Guangdong Province, 518112, China.
Department of Infectious Diseases, Linzhi People's Hospital, Linzhi, Tibet Autonomous Region, China.
BMC Pulm Med. 2024 Dec 18;24(1):611. doi: 10.1186/s12890-024-03427-6.
Adolescent pulmonary tuberculosis (TB) is considered inadequately recognized and underreported at high altitudes. This study aimed to investigate the clinical features of adolescent pulmonary TB patients at high altitudes in China.
A retrospective analysis was performed at Linzhi People's Hospital. Patients recruited were newly diagnosed with pulmonary TB. Detailed information, including demographics, medical history, presenting symptoms, laboratory results and pulmonary images, was collected. Sputum samples were collected to detect Mycobacterium tuberculosis via the GeneXpert MTB/RIF assay.
A total of 63 adolescents and 192 adults were recruited. Compared with those in the adult group, typical TB-related manifestations were significantly less common in the adolescent group (all P < 0.05). The adolescent group had significantly more subclinical TB (23.8% vs. 8.3%, P = 0.001) and a higher previous tuberculosis exposure rate (38.8% vs. 8.3%, P < 0.001) than did the adult group. The erythrocyte sedimentation rate was significantly higher in the adolescent group than in the adult group (P = 0.026). Compared with adult patients, adolescent patients presented a lower rate of pleural thickening (P < 0.01). Compared with active adolescent patients, there were more female than male in the adolescent subclinical TB group (12/15 vs 27/48) and the positive rate of the sputum GeneXpert test was higher in subclinical TB group (6/15 vs 8/48).
Adolescent patients with pulmonary TB at high altitudes were prone to subclinical TB and have a higher previous TB exposure rate. Sputum GeneXpert test and ESR were important for the diagnosis of subclinical pulmonary TB.
青少年肺结核在高海拔地区被认为未得到充分认识且报告不足。本研究旨在调查中国高海拔地区青少年肺结核患者的临床特征。
在林芝市人民医院进行回顾性分析。纳入的患者为新诊断的肺结核患者。收集详细信息，包括人口统计学、病史、症状表现、实验室检查结果和肺部影像。采集痰液样本，通过GeneXpert MTB/RIF检测法检测结核分枝杆菌。
共纳入63名青少年和192名成年人。与成人组相比，青少年组典型的肺结核相关表现明显较少见（所有P < 0.05）。青少年组亚临床肺结核显著更多（23.8% 对8.3%，P = 0.001），既往结核暴露率高于成人组（38.8% 对8.3%，P < 0.001）。青少年组红细胞沉降率显著高于成人组（P = 0.026）。与成年患者相比，青少年患者胸膜增厚率较低（P < 0.01）。与青少年活动性肺结核患者相比，青少年亚临床肺结核组女性多于男性（12/15对27/48），亚临床肺结核组痰液GeneXpert检测阳性率更高（6/15对8/48）。
高海拔地区青少年肺结核患者易患亚临床肺结核，既往结核暴露率较高。痰液GeneXpert检测和红细胞沉降率对亚临床肺结核的诊断很重要。
