Bruce R M, Wise L
Ann Intern Med. 1977 Nov;87(5):574-6. doi: 10.7326/0003-4819-87-5-574.
One hundred patients who underwent jejunoileal bypass for obesity were followed for a mean period of 2 1/2 years. Four patients developed a clinical illness that resembled a systemic form of tuberculosis during the first postoperative year. This incidence exceeds that found in the general population by sixtyfold. Any patient with jejunoileal bypass who develops an illness with accelerated weight loss, enlarged lymph nodes, and unexplained fever with chills should be suspected of having tuberculosis. Aggressive diagnostic measures are required. Treatment with isoniazid and ethambutol at usual doses can be successful, but blood levels should be measured to confirm adequacy until additional information becomes available.
对100例因肥胖接受空肠回肠分流术的患者进行了平均2年半的随访。4例患者在术后第一年出现了类似全身性结核病的临床疾病。这一发病率比普通人群高出60倍。任何接受空肠回肠分流术的患者，若出现体重快速下降、淋巴结肿大以及不明原因的发热伴寒战，都应怀疑患有结核病。需要采取积极的诊断措施。使用常规剂量的异烟肼和乙胺丁醇治疗可能会成功，但在获得更多信息之前，应检测血药浓度以确认药物剂量是否足够。
