Petukhova E Iu, Zaslavskaia R M, Teĭblium M M
Moskovskiĭ meditsinskiĭ stomatologicheskiĭ institut, Aktiubinskiĭ gosudarstvennyĭ meditsinskiĭ institut.
Klin Med (Mosk). 1997;75(7):33-5.
As shown by X-ray clinical and laboratory examinations of 495 patients over 18 years of age with primary tuberculosis of the respiratory organs, among primary forms of the specific process most prevalent are tuberculosis of the intrathoracic lymph nodes (tumor form), infiltrative tuberculosis with preroot or lower lobe location and exudative pleurisy. The peak of the incidence was reported in the group of 20-25-year-olds. The disease took an cute course with severe intoxication and symptoms of bronchopulmonary involvement in 45.3%, a torpid course with scare symptoms in 49.7% and a chronic course of primary tuberculosis in 5.0% of the examinees. Paraspecific reactions were observed in 5.9%, hyperergic tuberculin tests typical for primary tuberculosis in 10.9% of the cases. The examination of the sputum for bacterial and altered forms of M. tuberculosis raised frequency of the diagnosis verification by 16.0%. Respiratory tuberculosis in adults runs in the presence of marked disorders in lymphocyte T- and B-systems, antituberculous immunity and metabolic processes. Incidence rate and intensity of the above disorders correlate with severity of tuberculous intoxication and tuberculous lesions. The informative value of the complex of clinicoroentgenological and immunological tests in the diagnosis of primary tuberculosis varies from 44.4 to 79.6% and from 28.3 to 77.5% in dependence on the immunological and biochemical test, respectively.
对495例18岁以上呼吸器官原发性结核患者进行的X线、临床及实验室检查结果显示，在特异性病变的主要类型中，最常见的是胸内淋巴结结核（肿瘤型）、根前或下叶浸润性结核以及渗出性胸膜炎。发病率高峰出现在20至25岁年龄组。45.3%的患者病情呈急性，伴有严重中毒症状及支气管肺受累症状；49.7%的患者病情呈隐匿性，症状轻微；5.0%的受检者为原发性结核慢性病程。5.9%的患者出现副特异性反应，10.9%的病例有原发性结核典型的超敏结核菌素试验。痰液细菌学及结核分枝杆菌变异形式检查使诊断核实率提高了16.0%。成人呼吸道结核在淋巴细胞T和B系统、抗结核免疫及代谢过程存在明显紊乱的情况下发生。上述紊乱的发病率及强度与结核中毒及结核病变的严重程度相关。临床X线及免疫学检查综合手段在原发性结核诊断中的信息价值分别为44.4%至79.6%以及28.3%至77.5%，具体取决于免疫学及生化检查。
