Diagnostic and therapeutic problems of pulmonary tuberculosis in elderly patients.
Diagnostic and therapeutic problems of pulmonary tuberculosis in elderly patients.
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DOI：
10.3346/jkms.2005.20.5.784
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发表时间：
2005-10
影响因子：
4.5
通讯作者：
Chung HS
中科院分区：
文献类型：
--
作者：
Lee JH;Han DH;Song JW;Chung HS
为明确青年（<64岁）和老年（≥65岁）肺结核（TB）的临床、影像学和微生物学特征的差异，我们对207例青年和119例老年肺结核患者的病历和胸片进行了回顾性分析。咯血和发热感在年轻人中更常见，而虚弱、呼吸困难、厌食和精神改变在老年人中更常见。老年患者心血管疾病和慢性肺部疾病的发生率较高，而年轻患者基础肝病的比例较高。此外，胸部X线片显示老年人中肺结核病变累及中下肺的频率显著较高（10.6%对22.7%，p<0.05）。老年人常误诊为肺炎或肺癌。但两组痰抗酸杆菌阳性率无差异。老年人药物不良反应发生率较高（18.5% vs. 40.7%，p<0.05），结核病相关死亡率较高（1.3% vs. 11.1%，p<0.05）。总之，本研究表明，年轻和老年肺结核患者具有相似的微生物学特征;然而，老年人表现出更高的频率不典型的临床和放射学表现，药物不良反应，和更高的结核病相关死亡率。
To identify differences in the clinical, radiologic, and microbiologic features of pulmonary tuberculosis (TB) in the young (<64 yr) and elderly (≥65 yr), we performed a retrospective analysis of the medical charts and chest radiographs of 207 young and 119 elderly pulmonary TB patients. Hemoptysis and a febrile sense were more frequent in the young, whereas weakness, dyspnea, anorexia, and mental change were more frequent in the elderly. Elderly patients showed higher frequencies of cardiovascular and chronic lung diseases, whereas the young showed a higher proportion of underlying liver disease. In addition, chest radiography showed a significantly higher frequency of mid or lower lung involvement by TB lesions in the elderly (10.6% vs. 22.7%, p<0.05). Lesions were frequently misdiagnosed as pneumonia or lung cancer in the elderly. However, there was no difference between these two groups in terms of sputum acid-fast bacilli positivity. The elderly showed a higher frequency of adverse drug reactions (18.5% vs. 40.7%, p<0.05), and higher TB-related mortality (1.3% vs. 11.1%, p<0.05). In conclusion this study showed that young and elderly pulmonary TB patients have similar microbiologic features; however, the elderly showed higher frequencies of atypical clinical and radiologic presentations, adverse drug reactions, and higher TB-related mortality.
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影响因子：
9.6
作者：
KORZENIEWSKAKOSELA, M;KRYSL, J;FITZGERALD, JM
通讯作者：
FITZGERALD, JM
影响因子：
5.9
作者：
ALVAREZ, S;SHELL, C;BERK, SL
通讯作者：
BERK, SL
影响因子：
--
作者：
MORRIS, CDW
通讯作者：
MORRIS, CDW
影响因子：
24.3
作者：
Schaberg, T;Rebhan, K;Lode, H
通讯作者：
Lode, H
DOI：
10.1164/ajrccm.157.6.9711039
发表时间：
1998-06-01
影响因子：
24.7
作者：
Ungo, JR;Jones, D;Pitchenik, AE
通讯作者：
Pitchenik, AE