结核病是威胁人类健康的一种传染病。根据WHO 1988年报告,全球每年肺结核发病1000万人左右,而每年死于结核病的约有300万人。我国亦为结核病高发国家,据1985年调查推算,全国有活动性肺结核病人约570万人,每年死于结核病的达30余万人。肝脏结核做为结核病的重要组成部分也屡见报道。由于肝脏结核常无特异的症状和体征,临床诊断极易误诊。现就肝结核病的诊治问题提出探讨,以助于提高对该病的认识。 1 病因病理 1.1 结核病病因学的新问题结核菌的感染是结核病的确定病因。而艾滋病的发现和世界性流行给结核病的诊治提出了新挑战。美国在过去33年中结核病每年下降6.7%,而自1986～1990年反而上升2.6%～6%。这充分证明结核与HIV(人类免疫缺陷病毒)感染并存是美国和西欧以及非洲 Tuberculosis is a contagious disease that threatens human health. According to the WHO report of 1988, the annual incidence of tuberculosis in the world is about 10 million people, and about 3 million people die each year from tuberculosis. My country is also a high incidence of tuberculosis. According to the 1985 survey, there are about 5.7 million active tuberculosis patients nationwide and more than 300,000 people die of tuberculosis each year. Liver tuberculosis as an important part of tuberculosis is also frequently reported. Due to liver tuberculosis often no specific symptoms and signs, clinical diagnosis is extremely misdiagnosed. Now on the diagnosis and treatment of liver tuberculosis put forward to explore ways to help improve the understanding of the disease. 1 etiology and pathology 1.1 new problems of etiology of tuberculosis Mycobacterium tuberculosis infection is the identification of the etiology. The AIDS epidemic and the worldwide epidemic pose new challenges to the diagnosis and treatment of tuberculosis. Tuberculosis in the United States has decreased by 6.7% per year in the past 33 years, but increased by 2.6% -6% from 1986 to 1990. This fully proves that the coexistence of tuberculosis and HIV (human immunodeficiency virus) is the United States and Western Europe and Africa