2010 年世界卫生组织( WHO) 年度报告指出, 中国2009 年有110 万至150 万名结核患者, 并且每 10 万人口中即有新增病例50 至99 人。报告中也提到, 近年吸毒人数增多, 世界范围内有11% ～ 13% 的结核患者呈HIV 阳性。而在中国, 虽然仅有 1. 5% 的新增结核患者显示HIV 阳性, 比2007 年的 1. 9% 略有下降, 但中国结核病群体巨大, 其形势仍不容忽视[ 1, 2 ] 。
目的:探讨糖尿病合并结核病的临床特征、诊断和治疗。方法:分析总结了49例老年糖尿病合并结核病患者的临床资料,同时与老年单纯肺结核患者进行了对比。结果:两组临床症状无显著性差异,糖尿病合并肺结核组干酪渗出性病灶要多于单纯肺结核组(Plt;0.05),中、下叶病灶要多于单纯肺结核组(Plt;0.01)。两组疗效无显著性差异(Pgt;0.05)。 结论: 糖尿病合并结核病应引起高度重视,正确诊断和及时处理是提高疗效重要手段。
ObjectiveTo systematically review the trend of tuberculosis among Chinese students. MethodsPubMed, Web of Science, EMbase, CBM, WanFang Data and CNKI databases were electronically searched to collect cross-sectional studies on the incidence and trend of tuberculosis among students in China from inception to August 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, meta-analysis was performed by using Stata 15.0 software. ResultsA total of 97 cross-sectional studies were included. The results of meta-analysis showed that: the overall incidence of tuberculosis among students in China was 18.63 per 100 000 persons. The incidence in the northwest, south, northeast, north, east, central, and southwest 46.81, 11.22, 24.38, 12.77, 12.03, 18.95, and 39.26 per 100 000 persons, respectively. The incidence among university students, senior high school students, junior school students, and primary school students 38.17, 33.84, 8.85, and 1.68 per 100 000 persons, respectively. ConclusionCurrent evidence shows that the incidence of tuberculosis among students in China is high. Among them, the incidence rate of tuberculosis in the central and western regions, universities and high school students is relatively high.
【摘要】 目的 探讨粟粒性脑结核及与其需要鉴别疾病的MRI特点。 方法 2007年12月-2009年10月，对11例粟粒性脑结核患者的MRI平扫及增强表现进行分析，总结其MRI特征性表现。 结果 病史上粟粒性脑结核多存在血行播散型肺结核，平扫表现为多发小片影，增强后表现为弥漫分布的小环状或结节状强化灶，大小趋向一致，多为2 mm左右，可合并结核性脑膜炎及脑积水。 结论 粟粒性脑结核的MRI平扫表现不典型，增强表现有一定特征性，认识其特点可以和其它常见的颅内多发病变进行鉴别。【Abstract】 Objective To analyze the MRI appearances of cerebral military tuberculosis and other diseases that need to differentiate. Methods From December 2007 to October 2009, the MRI appearances of 11 cases on the plain scan and the enhanced MRI scan after injection of Gd-DTPA were reviewed and summarized. Results The cases of cerebral military tuberculosis usually had the history of military pulmonary tuberculosis, showed multiple lesions in fragments on plain scan, and the lesions distributed diffusely after enhancement, showed as ring form or nodosity. The size tended to be uniform, often 2 mm in diameter approximately. Tuberculosis meningitis and hydrocephalus could accompany. Conclusion The manifestation of plain MRI is not typical, and the enhancement MRI is imperative. Some characteristic appearances can be found after injection of Gd-DTPA, and these characteristic appearances could be helpful to differentiate with other multiple intracranial diseases.
目的:探讨脊柱结核一期内固定手术的围手术期处理方法。方法:一期手术治疗脊柱结核患者68例。围手术期处理主要包括正规化疗、围手术期营养支持、选择正确的手术时机、术后支具保护下逐步功能锻炼、定期随访、监测药物副作用等。结果:68例患者切口均一期愈合,无窦道形成。平均2.2 年随访,结核治愈、后凸畸形纠正,10 例患者出现化疗相关的并发症对症或调整药物后症状控制。结论:正确的围手术期处理是脊柱结核手术成功的重要保证。.
目的:糖尿病合并肺结核病的临床治疗效果的观察。方法:对我院2004~2008年收治糖尿病合并初治肺结核病56例患者的临床资料进行分析。结果:糖尿病合并初治肺结核病患者病情进展快,症状较重。血糖控制情况明显影响肺结核治疗效果。结论:积极控制血糖是治疗糖尿病合并初治肺结核病的关键。
ObjectiveTo investigate the clinical characteristics of non-tuberculous mycobacterium (NTM) pulmonary disease and pulmonary tuberculosis, as well as the bacterial distribution of NTM pulmonary disease. Methods The bacterial distribution and clinical characteristics of 104 patients with NTM lung disease hospitalized in Jiangxi Provincial People’s Hospital from May 2017 to May 2020 were retrospectively analyzed, as well as the clinicplal characteristics of 155 patients with tuberculosis hospitalized during the same period. Results The age of NTM lung disease group [(60±15) years] was higher than that of tuberculosis group [(55±19) years]. There were statistically significant differences in basic diseases (such as malignant tumor, type 2 diabetes, old tuberculosis, bronchiectasis), laboratory examination (such as blood routine examination, albumin) and chest imaging characteristics between the two groups (P<0.05). There was no significant difference in clinical symptoms (such as cough, sputum or fever) (P>0.05). The common underlying diseases of NTM lung disease were malignant tumor (29%), bronchiectasis (21%), chronic obstructive pulmonary disease (19%), etc. The common clinical symptoms of NTM lung disease included cough, sputum, fever, hemoptysis, chest tightness and shortness of breath, and other non-specific respiratory symptoms. The common manifestations of NTM lung disease on chest high-resolution CT (HRCT) included patchy images (82%), mediastinal lymph node enalargement (35%), pleural thickening (31%), pleural effusion (26%) and other signs. The isolates of NTM included Mycobacterium avium (50%), Mycobacterium intracellulare (21%), Mycobacterium chelonae/abscessus (14%), Mycobacterium fortuitum (5%), Mycobacterium gordonae (4%), Mycobacterium gilvum (3%), and Mycobacterium smegmatis (3%). Multivariate Logistic regression analysis showed that advanced age (OR=1.027) was a risk factor for NTM lung disease. Conclusions The clinical manifestations of NTM lung disease and tuberculosis are similar and difficult to distinguish. For male patients over 60 years old with malignant tumor, old tuberculosis, bronchiectasis and other basic diseases, and the chest HRCT findings are mainly bronchiectasis, NTM lung disease should be actively excluded. There is little difference in clinical manifestations between different strains of NTM lung disease, and the treatment cycle of NTM lung disease is long and easy to be interrupted, requiring enhanced follow-up.