風(fēng)濕免疫性疾病合并血行播散性肺結(jié)核的臨床特征分析

打開文本圖片集

中圖分類號：R521 文獻標(biāo)志碼：A 文章編號：1001-8751（2025）02-0091-05

Clinical Characteristics Analysis of Rheumatic Immune Disease Combined with Hematogenous Disseminated Pulmonary Tuberculosis

ShenYao，Huang Tao，LiXiu （Public Health Clinical Center of Chengdu， Chengdu 610011）

Abstract： ObjectiveTo investigate the clinical features of individuals who have hematogenous disseminated pulmonary tuberculosis inaddition to rheumaticand immunological disorders，and to serve as aresource for clinical work pertaining to these conditions.MethodsThe clinical data of 63 patients with rheumatic immune diseases complicated with hematogenous disseminated pulmonary tuberculosis from January 2022 to April 2023 in a tuberculosis special hospital in Chengdu， includingdemographicdatahistoryof immunosuppresiveagents，sputum etiologyand blood immunology，were analyzed retrospectively.ResultsMen had a greater incidence rate （65.1%） than women（ 34.9% ）among 63 patients with rheumatic immunological disorders accompanied with hematogenous disseminated pulmonary tuberculosis. In terms of the classification of rheumatism， gout （30.2%） and rheumatoid arthritis （23.8%） ）were the main diseases.Most patients have common fever（ （71.4%） and cough （65.1%） as their first clinical manifestations. The imaging examination mainly showed pleural efusion/pleural thickening （60.3%） ，Most patients are in an immunocompromised state （54.0%） . There was no statistically significant difference in T lymphocyte count and sputum bacterial positivity rate between patients with hematogenous disseminated pulmonary tuberculosis who used and did not use anti-rheumatic immune drugs.ConclusionMen make up a greater proportion than women among patients with rheumatic immunological disorders accompanied by hematogenous diseminated pulmonary TB， andthe disease primarily affects middle-aged and older adults.The useof anti-rheumatic drugs may increase the risk oftuberculosis，andits clinical manifestations areoftenatypical.Earlyscreeningandidentification，timelytreatment， and improved prognosis are needed.

Key words： rheumatoid immune disease；hematogenous dissemination；pulmonary tuberculosis；clinical features； prognosis； retrospective analysis

風(fēng)濕免疫性疾病是一組不明原因?qū)е陆Y(jié)締組織受累的自身免疫性疾病，主要侵犯骨關(guān)節(jié)、肌肉、骨骼及關(guān)節(jié)周圍的軟組織，引起疼痛、腫脹和僵硬，并可以導(dǎo)致全身多系統(tǒng)損害，主要包括有類風(fēng)濕性關(guān)節(jié)炎、系統(tǒng)性紅斑狼瘡、強直性脊柱炎、干燥綜合征、皮肌炎、銀屑病關(guān)節(jié)炎和痛風(fēng)性關(guān)節(jié)炎等，其發(fā)病機制尚未完全闡明，但共同特點是機體免疫功能紊亂。（剩余6766字）