70세 이상의 고령에서 발생한 기관지 결핵의 임상적 특징
Clinical Characteristics of Endobronchial Tuberculosis that Develops in Patients over 70 Years of Age
김현식 (한국체육대학교)
정이영 (경상대학교)
전경녀 (경상대학교)
이종덕 (경상대학교)
황영실 (경상대학교)
김호철 (경상대학교)
마정은 (경상의대)
이승준 (경상의대)
함현석 (경상의대)
조유지 (경상의대)
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초록
연구배경: 폐결핵의 발생은 연령이 증가함에 따라 그 빈도가 증가하는 것으로 알려져 있어 기관지 결핵의 발생률도 고령에서 증가할 것으로 생각된다. 본 연구는 70세 이상의 고령에서 발생한 기관지 결핵의 임상적 특징을 알아보고자 하였다. 방 법: 2003년 3월부터 2006년 6월까지 경상대학교병원에서 기관지 결핵으로 진단 받은 74명의 환자(남：여=12：62, 평균나이: 64.6±16.2세)를 대상으로 70세 이상 환자군과 70세 미만 환자군으로 나누어 임상적 특징을 후향적으로 조사하였다. 결 과: 1) 70세 이상의 환자는 41명(55%), 70세 미만의 환자는 33명(45%)이었다. 2) 양군 모두에서 가장 흔한 증상은 기침이었으며, 호흡곤란의 빈도는 70세 이상 환자군이 70세 미만 환자군보다 높았다(31.7% vs. 12.1%). 3) 기관지내시경 소견상 70세 이상의 환자군이 70세 미만의 환자군보다 건락성 괴사형의 비율은 낮았고(39% vs. 66.7%), 부종 충혈형은 상대적으로 높았다(53.7% vs. 27.2%)(p＜0.05). 4) 병변의 위치는 기관 또는 주 기관지를 침범하는 경우가 70세 이상의 환자군이 70세 미만의 환자군보다 유의하게 많았다(9.7% vs. 30.3%). 5) 객담 및 기관지 세척액의 항산균 도말 양성률과 배양 양성률은 유의한 차이가 없었다.
- keywords
- Endobronchial tuberculosis, Older people, Clinical characteristics, Endobronchial tuberculosis, Older people, Clinical characteristics
Abstract
Background: The possibility of developing pulmonary tuberculosis usually increases with increasing age. Therefore, the incidence of endobronchial tuberculosis in older people may increase. We evaluated the clinical characteristics in patients with endobronchial tuberculosis above the age of 70 years. Methods: We enrolled 74 patients (12 males and 62 females; mean age 64.6±16.2 years) that were diagnosed with endobronchial tuberculosis from March 2003 to July 2006 at Gyeongsang University Hospital. We retrospectively evaluated the clinical characteristics of endobronchial tuberculosis for patients 70 years or older (older group) and for patients below the age of 70 years (younger group). Results: The number of patients in the older group was 41 (55%). Cough was the most common symptom in the two groups of patients and dyspnea on exertion was more common in the older group of patients than in the younger group of patients (31.7% vs. 12.1%). The actively caesating type of disease was more common in the younger group of patients than in the older group of patients (66.7% vs. 39%). The edematous type of disease was more common in the older group of patients than in the younger group of patients (53.7% vs. 27.2%) (p＜0.05). Tracheal and main bronchial involvement of lesions were more common for the younger group of patients than for the older group of patients (30.3% vs. 9.7%) (p＜0.05). Conclusion: Endobronchial tuberculosis was commonly observed in patients older than 70 years and this group of patients had some clinical characteristics that were different from the younger group of patients. (Tuberc Respir Dis 2007;63:412-416)
- keywords
- Endobronchial tuberculosis, Older people, Clinical characteristics, Endobronchial tuberculosis, Older people, Clinical characteristics
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