Moudgil H, Sridhar G, Leitch A G
Department of Medicine, University of Edinburgh, City Hospital, U.K.
Respir Med. 1994 Apr;88(4):301-4. doi: 10.1016/0954-6111(94)90060-4.
From 1980-1991 82 (7.2%) of 1134 tuberculosis notifications in Edinburgh were for pleural effusion. Study of the available records of 62 cases satisfying defined diagnostic criteria identified 14 cases (6 M, 8 F) with a mean age of 27.6 years (range 11-51 years) of primary tuberculous effusion and 25 cases (21 M, 4 F) with a mean age of 51 years (range 19-79 years) with pleural effusion due to reactivation disease. Twenty-three patients (19 M, 4 F) with a mean age of 48.9 years (range 25-85 years) defied classification. Symptoms, associated and diagnostic test findings were similar in all three groups of patients. Parenchymal radiographic shadowing was seen in 1/14 primary, 16/25 reactivation and 3/25 unclassified pleural effusions. Twenty-three of 30 patients treated with corticosteroids showed no residual radiographic abnormality compared to 17/30 not so treated (P < 0.06). Reactivation disease is currently a commoner cause of tuberculous pleural effusion than primary disease in Edinburgh. We suggest that the unclassified cases, so similar in age and sex to the defined reactivation disease cases, also represent largely extrapulmonary reactivation disease occurring in middle age.
1980年至1991年期间，爱丁堡1134例结核病通报中有82例（7.2%）是胸膜腔积液。对62例符合明确诊断标准的现有记录进行研究，确定了14例原发性结核性积液病例（6例男性，8例女性），平均年龄27.6岁（范围11至51岁），以及25例因疾病复发导致胸膜腔积液的病例（21例男性，4例女性），平均年龄51岁（范围19至79岁）。另有23例患者（19例男性，4例女性），平均年龄48.9岁（范围25至85岁），无法分类。三组患者的症状、相关检查及诊断性检查结果相似。在14例原发性、16例复发及25例未分类的胸膜腔积液中，分别有1例、16例及3例出现实质性放射影像学阴影。接受皮质类固醇治疗的30例患者中，23例未遗留放射影像学异常，未接受该治疗的30例患者中，这一比例为17例（P < 0.06）。在爱丁堡，目前疾病复发是结核性胸膜腔积液比原发性疾病更常见的病因。我们认为，那些在年龄和性别上与明确的疾病复发病例相似的未分类病例，很大程度上也代表了中年发生的肺外疾病复发。
