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目的 :为了观察分析结核菌纯蛋白衍化物 (PPD) 5U阴性之初治肺结核病人的临床表现及诊疗特点。方法 :选择 1997年 3月～ 1999年 6月我院收治的PPD 5U阴性肺结核病人 6 8例 ,并随机选择同期PPD皮试阳性肺结核病人 80例 ,就其临床症状、体征、痰菌、X片及近期疗效等进行比较。结果 :PPD 5U阴性的肺结核病人呼吸道症状少 ,全身中毒症状多 ,X片病灶广泛 ,痰菌阳性率低 ,合并症多 ,强化期疗效不理想。结论 :PPD 5U阴性之结核病人往往存在一定程度的细胞免疫损害 ,全身症状相对多见 ,病灶有不易局限而广泛的倾向 ,痰菌阳性率低 ,且近期疗效较差 ;诊断上应重视X线、CT、抗体和病理学等特点 ,分析病因 ;治疗上应在抗结核的同时 ,积极治疗合并症、并发症 ,重视免疫调节剂的应用 ,以改善免疫功能低下的状况
Objective: To observe and analyze the clinical manifestations and diagnosis and treatment of newly diagnosed pulmonary tuberculosis (TB) patients with 5U-negative tuberculus pure protein derivative (PPD). Methods: From March 1997 to June 1999, 68 patients with PPD 5U-negative pulmonary tuberculosis admitted to our hospital were selected and randomly selected 80 patients with PPD-positive pulmonary tuberculosis in the same period. Their clinical symptoms, signs, sputum, X-ray And the recent efficacy compared. Results: PPD 5U-negative pulmonary tuberculosis patients had less respiratory symptoms, systemic symptoms of poisoning, extensive X-ray lesions, low positive sputum bacilli, more complications, and poor efficacy in intensive phase. CONCLUSIONS: PPD 5U-negative TB patients often have a certain degree of cellular immune damage, systemic symptoms are relatively common, the lesions are not easy to limit and widespread tendency, the positive rate of sputum bacteria is low, and the recent curative effect is poor; the diagnosis should pay attention to the X-ray , CT, antibody and pathology, analysis of the etiology; treatment should be in the anti-tuberculosis at the same time, active treatment of complications, complications, emphasis on the application of immunomodulators to improve the status of immune dysfunction