合并慢性空洞性肺曲霉病的肺结核咯血患者临床特征及危险因素分析OACSTPCD

Objective Analysis of clinical characteristics for pulmonary tuberculosis hemoptysis patients complicated with chronic cavitary pulmonary aspergillosis(CCPA)and to investigate the risk factors.Methods Retrospective analysis of 57 cases diagnosed pulmonary tuberculosis hemoptysis with CCPA patients,and 57cases diagnosed pulmonary tuberculosis he-moptysis with non-CCPA patients were randomly selected as the control group.The clinical characteristics,auxiliary exami-nation,diagnosis and treatment and prognosis of patients in the two groups were compared.Risk factors were analyzed by bi-nomial logistic regression.Results Compared with the non-CCPA group,the CCPA group was prone to massive hemopty-sis,had a long-term smoking history,and had more obvious clinical symptoms such as emaciation,anhelation and fatigue,often accompanied by decreased hemoglobin and serum albumin levels(P＜0.05).There were residual cavities in lung ima-ging of patients with CCPA and 54.38％had ball-in-hole sign,The positive rates of blood galactomannan antigen test,fungal culture and fungal immunofluorescence staining were 54.38％、38.59％and 70.17％,respectively.The patient's condition was stable after surgical resection and antifungal treatment for at least 6 months.Logistic binary analysis showed that the risk factors of pulmonary tuberculosis hemoptysis patients with CCPA were long-term smoking history,body mass index＜18.5 kg/m2,serum albumin＜35 g/L(P＜0.5).Conclusion Pulmonary tuberculosis patients with residual cavities are easy to be complicated with CCPA,often accompanied by massive hemoptysis.It is necessary to improve the diagnosis of fungal culture,fungal immunofluorescence staining,pathological diagnosis,and timely comprehensive treatment such as an-tifungal and surgery to improve the prognosis.