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目的探讨长期使用糖皮质激素诱发肺结核的临床特点、诊断和预后。方法采用回顾性病例调查的方法 ,对 3 0例长期使用激素并发肺结核的患者进行临床分析。结果原发病中结缔组织病 2 8例 ,肺间质纤维化 1例 ,支气管哮喘 1例。激素使用剂量 10～ 80 mg/d,时间 2个月～ 15年。并发血行播散型肺结核 12例 ,浸润型肺结核 14例 ,单纯性胸膜炎 2例 ,多发性浆膜腔积液 2例。临床表现、X线特点和实验室检查均不典型。结论长期使用激素易诱发肺结核或导致原来肺结核恶化。对长期使用激素的患者应提高警惕 ,必要时给予预防性抗痨治疗
Objective To investigate the clinical features, diagnosis and prognosis of long-term glucocorticoid-induced pulmonary tuberculosis. Methods The retrospective case investigation method was used to analyze the clinical data of 30 patients with long-term use of hormone and pulmonary tuberculosis. Results The primary disease in 28 cases of connective tissue disease, pulmonary fibrosis in 1 case, bronchial asthma in 1 case. Hormone dose of 10 ~ 80 mg / d, time 2 months to 15 years. Twelve cases of hematogenous disseminated tuberculosis, 14 cases of infiltrative pulmonary tuberculosis, 2 cases of simple pleurisy, and 2 cases of multiple serous effusions. Clinical manifestations, X-ray features and laboratory tests are not typical. Conclusion Long-term use of hormones easily induce tuberculosis or lead to deterioration of the original tuberculosis. For long-term use of hormones in patients should be vigilant, if necessary, prophylactic anti-tuberculosis treatment