肋膜結核之臨床特徵

Clinical Features of Pleural Tuberculosis

Purpose: Pleural tuberculosis is a common and important disease in Taiwan. Previous studies have not focused on the sex differences of pleural tuberculosis. The purpose of the study was to elucidate the clinical features and sex difference in the presentation of pleural tuberculosis. Method: We retrospectively reviewed the medical records of patients with pleural tuberculosis who initiated therapy at a regional hospital in northem Taiwan between January 2003 and March 2008. The identified characteristics were analyzed and compared in males and females. Results: Thirty-three patients (24 males and 9 females) with a mean age of 65.8±20.8 years were enrolled into our study. There was a much higher proportion of right pleural involvement than the left and bilateral cases (66.7% vs. 24.2% vs.9.1%), especially in females (88.9% vs. 11.1% vs. 0.0%). More male than female patients were former or current smokers (58.3% vs. 11.1 %, p=0.021), had concurrent pulmonary tuberculosis (37.5% vs. 0.0%, p=0.039), and weakness (58.3% vs. 11.1%, p=0.021). The neutrophil count was higher in males (6.0±2.9 vs. 4 .3±1.4╳109/L, p=0.033). The creatinine level was also higher in males (107±40 vs. 77±19μmol/L, p=0.006). Condusion: Our study expands the knowledge of the clinical features of pleural tuberculosis. The patients with pleural tuberculosis are male-predominant and older in Taiwan. There are indeed sex differences in the presentation of pleural tuberculosis in Taiwan. 目的：肋膜結核是台灣的盛行及重要疾病，以往的研究並未探討肋膜結核的性別差異性。本研究的目的在探討肋膜結核的臨床特徵與性別差異性。方法：我們回溯式檢視2003年一月至2008年三月問北台灣某區域醫院肋膜結核病患的病歷，分析病患的臨床特徵與性別差異性。結果：本研究共回顧33位病患(24位男性與9位女性)的病歷，其平均年齡為65.8±20.8歲。右側肋膜侵犯的比率遠高於左側及兩側侵犯(66.7% vs. 24.2% vs. 9.1%) ，尤其是女性病患(88.9% vs. 11.1% vs. 0.0%) 。男性病患比女性病患較常有吸煙史(58.3% vs. 11.1%，P=0.021) 、並存的肺結核(37.5% vs. 0.0%，p=0.039) 、以及虛弱無力的症狀(58.3% vs. 1 1. 1%，p=0.021) 。男性病患的嗜中性白血球數目( 6.0±2.9 vs. 4.3±1 .4╳109/L，p=0.033) 及肌酸酐(1 07±40 vs. 77±19μmol/L， p=0.006) 比女性病患高。結論：本研究增加了對於肋膜結核臨床特徵的認識，台灣的肋膜結核病患以男性為主且年紀較大，肋膜結核存在著性別差異性。