PREDICTORS OF SHORT-TERM PROGNOSIS IN PATIENTS WITH PULMONARY TUBERCULOSIS
PREDICTORS OF SHORT-TERM PROGNOSIS IN PATIENTS WITH PULMONARY TUBERCULOSIS
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DOI：
10.1093/infdis/158.2.366
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发表时间：
1988-08-01
影响因子：
6.4
通讯作者：
MODLIN, RL
中科院分区：
文献类型：
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作者：
BARNES, PF;LEEDOM, JM;MODLIN, RL
我们评估了191例连续的成人肺结核患者，以制定方法来确定哪些患者应该首先住院。使用逐步判别分析，我们发现了与不利的短期结果（呼吸衰竭或死亡）最密切相关的六个因素：淋巴细胞减少症、高龄、伴随的痰涂片阳性肺外结核、酗酒、分类白色血细胞计数中高百分比的中性粒细胞和缺乏空洞的放射学证据。我们得出了一个评分系统，将这些变量和分离的患者分为高风险和低风险组。该系统进行了前瞻性验证，将其应用于一个单独的组179例患者。32例患者的淋巴细胞转化试验显示，预后不良的临床标志物与热灭活结核分枝杆菌菌株的最小淋巴细胞增殖之间存在关联。
We evaluated 191 consecutive adults with pulmonary tuberculosis in order to develop methods to determine which patients should be initially hospitalized. Using stepwise discriminant analysis, we found the six factors that were most strongly associated with an unfavorable short-term outcome (respiratory failure or death):lymphopenia, advanced age, concomitant smear-positive extrapulmonary tuberculosis, alcoholism, a high percentage of neutrophils on the differential white blood cell count, and lack of radiographic evidence of cavitation. We derived a scoring system incorporating these variables and separated patients into high- and low-risk groups. The system was prospectively validated by applying it to a separate group of 179 patients. Lymphocyte-transformation tests in 32 patients revealed an association between clinical markers of poor prognosis and minimal lymphocyte proliferation to a heat-killed strain of Mycobacterium tuberculosis.