PULMONARY TUBERCULOSIS IN ELDERLY MEN
PULMONARY TUBERCULOSIS IN ELDERLY MEN
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DOI：
10.1016/0002-9343(87)90106-9
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发表时间：
1987-03-23
影响因子：
5.9
通讯作者：
BERK, SL
中科院分区：
文献类型：
--
作者：
ALVAREZ, S;SHELL, C;BERK, SL
比较29例青年男性和35例老年男性肺结核患者的临床表现、诱发因素和诊断方法。老年男性有更多的潜在疾病，如动脉粥样硬化，胃切除术和恶性肿瘤，而酗酒在年轻组中更普遍。在年轻组中，结核病的典型症状和体征的比例明显较高：发热（62%对31%），体重减轻（76%对34%），盗汗（48%对6%），痰液产生（76%对48%）和咯血（40%对17%）（p < 0.05）。精神状态异常在老年组中更为常见（31%对10%）（p < 0.05）。两组的影像学结果相似。与肺结核相关的死亡率在老年男性中为20%，而在年轻男性中为3%（p < 0.05）。当老年患者出现多种医学问题和非特异性主诉时，结核病通常不会被考虑在鉴别诊断中。由于老年肺结核患者的临床表现和预后存在差异，因此应保持对该病的高度怀疑。
The clinical manifestations, predisposing factors, and diagnostic approach to 29 young men and 35 elderly men with pulmonary tuberculosis admitted to a Veterans Administration hospital were compared. Elderly men had a higher number of underlying conditions such as atherosclerosis, previous gastrectomy, and malignancy, whereas alcoholism was more prevalent in the young group. The classic symptoms and signs of tuberculosis were noted in a significantly higher proportion of the younger group: fever (62 percent versus 31 percent), weight loss (76 percent versus 34 percent), night sweats (48 percent versus 6 percent), sputum production (76 percent versus 48 percent), and hemoptysis (40 percent versus 17 percent) (p < 0.05). Abnormal mentation was more common in the elderly group (31 percent versus 10 percent) (p < 0.05). Radiographic findings were similar in both groups. Mortality related to tuberculosis was 20 percent in elderly men versus 3 percent in the younger men (p < 0.05). Tuberculosis is frequently not considered in the differential diagnosis when elderly patients present with multiple medical problems and nonspecific complaints. Since there are differences in the clinical presentation and the outcome of pulmonary tuberculosis in elderly patients, a high index of suspicion for the disease should be maintained.