风湿免疫性疾病合并血行播散性肺结核的临床特征分析

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中图分类号：R521 文献标志码：A 文章编号：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

风湿免疫性疾病是一组不明原因导致结缔组织受累的自身免疫性疾病，主要侵犯骨关节、肌肉、骨骼及关节周围的软组织，引起疼痛、肿胀和僵硬，并可以导致全身多系统损害，主要包括有类风湿性关节炎、系统性红斑狼疮、强直性脊柱炎、干燥综合征、皮肌炎、银屑病关节炎和痛风性关节炎等，其发病机制尚未完全阐明，但共同特点是机体免疫功能紊乱。（剩余6766字）