Arriero J M, Romero S, Hernández L, Candela A, Martín C, Gil J, Fernández C
Respiratory Service, Hospital General Universitario de Alicante, Spain.
Int J Tuberc Lung Dis. 1998 Jun;2(6):513-7.
A community teaching hospital in Alicante, Spain.
To assess the characteristics of tuberculous pleurisy (TP) in our hospital, and to evaluate the differences between primary and reactivation forms.
Between January 1984 and December 1993, all human immunodeficiency virus (HIV)-negative patients with TP were included in the study. From September 1987 onward, patients were prospectively studied. Charts, radiography, pleural fluid findings and diagnostic methods were evaluated. Two groups were distinguished according to chest radiographs: those patients with upper lobe lesions, calcified adenopathy and old pleural thickening were considered reactivation forms.
Of the 129 patients (mean age, 31 +/- 18 years), 76% had primary TP and 24% reactivation TP. Differences were found in age (28 +/- 17 vs 40 +/- 18 years, P < 0.01), smoking (43% vs 74%, P < 0.01) and alcohol abuse (23% vs 47%, P < 0.05), weight loss (29% vs 50%, P < 0.05), positive sputum smears and cultures (2% vs 16%, 7% vs 28%, P < 0.01), and number of large effusions (46% vs 26%, P < 0.05), but not in tuberculin reactivity, pleural fluid findings, positive pleural cultures, or presence of pleural granuloma.
In our setting, TP predominantly affects young adults. Clinical, immunological, and pleural findings are similar to those of patients with classic symptoms of TP. Older age, smoking and alcohol abuse, smaller effusions and sputum yield are differential characteristics of reactivation forms.
西班牙阿利坎特的一家社区教学医院。
评估我院结核性胸膜炎（TP）的特征，并评估原发性和再激活型之间的差异。
1984年1月至1993年12月期间，所有人类免疫缺陷病毒（HIV）阴性的TP患者均纳入研究。从1987年9月起，对患者进行前瞻性研究。评估病历、影像学检查、胸腔积液检查结果和诊断方法。根据胸部X线片分为两组：有上叶病变、钙化淋巴结病和陈旧性胸膜增厚的患者被视为再激活型。
129例患者（平均年龄31±18岁）中，76%为原发性TP，24%为再激活型TP。在年龄（28±17岁对40±18岁，P<0.01）、吸烟（43%对74%，P<0.01）、酗酒（23%对47%，P<0.05）、体重减轻（29%对50%，P<0.05）、痰涂片和培养阳性（2%对16%，7%对28%，P<0.01）以及大量胸腔积液的数量（46%对26%，P<0.05）方面存在差异，但在结核菌素反应性、胸腔积液检查结果、胸膜培养阳性或胸膜肉芽肿的存在方面无差异。
在我院，TP主要影响年轻人。临床、免疫学和胸膜检查结果与TP典型症状患者相似。年龄较大、吸烟和酗酒、胸腔积液较少和痰菌阳性率较高是再激活型的差异特征。
