论文部分内容阅读
目的探索强直性脊柱炎合并肺结核患者的临床表现、影像学、治疗和预后。方法收集2013年6月-2016年9月天津市海河医院3年来强直性脊柱炎合并肺结核患者58例,分析临床表现、影像、治疗和预后。结果肺结核合并强直性脊柱炎(AS)患者58例,男性55例,女性3例,平均年龄54岁。AS病史2~50年不等,咯血为主诉的29例。TSPOT.TB阳性33例,痰XpertMTB/RIF阳性30例。19例患者完成疗程后,4例病变复发。10例患者因消化道症状自行停药。29例患者治疗中,其中14例患者因消化道症状不能耐受四联抗结核药物。结论强直性脊柱炎合并肺结核患者多表现咳嗽、咯血,影像学多见支气管扩张症及破坏肺,治疗中易胃肠道症状,治疗后易复发,治疗时间应延长。
Objective To explore the clinical manifestations, imaging, treatment and prognosis of patients with ankylosing spondylitis complicated with pulmonary tuberculosis. Methods Fifty-eight patients with ankylosing spondylitis and pulmonary tuberculosis in Haihe Hospital of Tianjin City from June 2013 to September 2016 were collected and their clinical manifestations, imaging, treatment and prognosis were analyzed. Results 58 cases of pulmonary tuberculosis with ankylosing spondylitis (AS), 55 males and 3 females, mean age 54 years. AS history of 2 to 50 years, 29 cases of primary complaint of hemoptysis. TSPOT.TB positive in 33 cases, sputum XpertMTB / RIF positive in 30 cases. After completion of the course of treatment in 19 patients, 4 lesions recurred. Ten patients discontinued due to gastrointestinal symptoms. Among the 29 patients treated, 14 patients were unable to tolerate quadruple anti-TB drugs due to gastrointestinal symptoms. Conclusions Patients with ankylosing spondylitis complicated with pulmonary tuberculosis often show cough and hemoptysis. Bronchiectasis and destruction of the lung are common in the imaging. Gastrointestinal symptoms are easily treated during treatment. The recurrence after treatment is easy and the treatment time should be prolonged.