Clinical Feature Analysis Of BALF Acid-fast Bacilli Positive Tuberculosis And Atypical Pneumonia

Objective: In order to provide the evidence for reducing clinical misdiagnosis and mistherapy,we carried out a pilot study of clinical indicators of BALF acid-fast bacilli positive tuberculosis and atypical pneumonia,to estimate their differential dagnosis value.Methods:The study reviewed the TB cases who were admitted to the Hebei thoraopathy hospital from Feb. 2010 to Dec. 2010.We selected 100 cases as tuberculosis group,which were positive in BALF TB-DNA real-time fluorescence quantitative PCR,matched by gender and age,100 cases of atypical pneumonia were selected as pneumonia groups,to analyze the clinical feature.All cases had complete information included clinical data and imageing data.Use uniformed questionnaire to collect the Patients' general condition(including gender,age,occupation,marital status,etc. demographic characteristics),clinical features(including symptom,signs,the previous medical history,family history,etc.),laboratory tests(including routine blood,biochemical,serologic test,sputum examination,etc.),imaging examination (high-resolution CT) etc. Established excel database, SPSS 13.0 statistics software was used to analyze the result and P<0.05 was significance standard.Result: 1.In the two groups of cases, percentage of famers was the lagest, the students were next.Percentage of famers in tuberculosis group was higher than peumonaire group,while percentage of students was higher in pneumonia group (p<0.05).2.The percentage of cough, low fever in the afternoon,sweats,fatigue, anorexia and weight loss were high in tuberculosis group,while chills was more freqently founded in pneumonia group.3.The results of comparing two groups of temperature showed that low fever was more freqently founded in tuberculosis group,high fever more in pneumonia group.While the results of fever times showed that patients in tubercuilosis group who had a fever in the afternoon were more than pneumonia group,the temperature of pneumonia group was without time rule(p<0.05).4.In our study,the time of cough in tuberculosis group was significantly longer than pneumonia group,percentage of yellow sputum was high in tuberculosis ,while the white sputum patients were more in pneumonia group(p<0.05).5. Auscultation of the lungs in tuberculosis group had a quieter than normal,accompanying crack significantly,while in the pneumonia group ,auscultation of the lungs was rougher than normal,and without crack(p<0.05).6. White blood count was most in the normal range.It was high in tuberculosis patients,but in pneumonia patients it was lower than normal(P<0.05).7.The concentrations of ALT,AST,ALP were lower in tuberculosis group,while the congcentration of hsCRP,ESR higher in it.The detected positive rate of ALT,AST,ALP,GGT was lower in tuberculosisi group,but the detected positive rate of ALB was higher in pneumonia group(p<0.05).8.The positive percentage of tuberculin experiment , tuberculosis anti-body and sputum smear in tuberculosis group were all more than pneumonia group(p<0.05).9.The tuberculosis group has a Long hospital days(p<0.05).10.All the 200 patients was abnormal in chest CT examination.In the tuberculosis group,the lesions distributed in both sides of lung,but in pneumonia group it distributed in one side of lung or single lobectomy.The image was diversified in tubeculosis(p<0.05).11. Through the multi-factor conditioned logistic regression analysis, factors that were finally left in the equation were l Long time cough, anorexia, weight loss, detect rales, PPD skin test, tuberculosis antibody, pleural effusion.Conclusions: Long time cough, anorexia, weight loss, detect rales, PPD skin test, tuberculosis antibody, pleural effusion were the main forecast factors of tuberculosis, these indicators in a cases appear more centralized, more pointed out the case for the likelihood of tuberculosis.