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目的:探讨精神分裂症合并肺结核患者的流行病学、临床与影像学特征。方法:对住院的3 285例精神分裂症患者进行肺结核调查,调查方法为胸部透视、摄片、彩色多普勒超声检查、结核菌素试验。结果:3 285例精神分裂症患者中发现患肺结核69例,占2.1%,其中男60例,占86.9%(60/69),女9例13.0%(9/69),男性比例明显高于女性;69例中Ⅱ型肺结核4例,占5.8%,Ⅲ型肺结核54例,占78.2%,Ⅳ型肺结核7例,占10.1%,Ⅲ型合并Ⅳ型4例,占5.8%。对于胸腔积液诊断彩色多普勒超声检查优越于X线检查,两者联合检查可以提高诊断符合率。结论:精神分裂症患者是肺结核的高发人群,肺部X线表现以Ⅲ型肺结核多见,且病情重,病变广,疗效差,易交叉感染,应引起精神科及传染科的高度重视,以便患者得到早期诊断、规范治疗,防止交叉感染及暴发流行。
Objective: To investigate the epidemiological, clinical and radiological features of patients with schizophrenia complicated with pulmonary tuberculosis. Methods: A total of 3 285 schizophrenic patients in hospital were investigated for pulmonary tuberculosis by chest fluoroscopy, radiography, color Doppler ultrasonography and tuberculin test. Results: 69 cases of tuberculosis were found in 3 285 cases of schizophrenia, accounting for 2.1%, including 60 males (86.9%) and 9 males (13.0%), the proportion of males was significantly higher than that of males Female; 69 cases of type Ⅱ tuberculosis in 4 cases, accounting for 5.8%, Ⅲ type tuberculosis in 54 cases, accounting for 78.2%, type Ⅳ tuberculosis in 7 cases, accounting for 10.1%, Ⅲ type Ⅳ in 4 cases, accounting for 5.8%. For the diagnosis of pleural effusion color Doppler ultrasound superior to X-ray examination, a combination of the two can improve diagnostic accuracy. Conclusions: Patients with schizophrenia are high-risk patients with pulmonary tuberculosis. Pulmonary X-ray findings are more common in patients with type III pulmonary tuberculosis and are characterized by severe illness, extensive disease, poor efficacy and cross-infection. Psychiatry and infectious diseases should be given high priority so that Patients get early diagnosis, standard treatment, to prevent cross-infection and outbreaks.