【摘要】目的分析维持性血液透析患者合并肺结核与普通人群肺结核的临床特点。方法回顾性分析郑州市第六人民医院2017 年1 月～2019 年5 月收治的维持性血液透析合并肺结核患者78 例为观察组，另选取同时期住院的普通人群肺结核患者110 例作为对照组，比较2 组患者临床资料。结果2组患者临床症状相比，咳嗽咳痰(χ2=0.282, P=0.595)、发热(χ2=1.709, P= 0.091)、盗汗(χ2= 1.489, P =0.222)、咯血(χ2=0.656, P =0.418)、胸闷胸痛(χ2=1.472,P =0.232)、乏力(χ2=1.374,P =0.241)无显著差异；2 组实验室检查相比结核抗体阳性率(χ2=3.910,P =0.048)、T-SPOT 阳性率(χ2=4.034,P =0.045)、红细胞沉降率(χ2=5.691,P =0.017)、痰涂片查抗酸杆菌阳性率(χ2=3.910,P =0.048) 及病灶≥3 个肺叶(χ2=4.201, P =0.040)存在统计学差异；应用抗结核药后，2 组不良反应相比，恶心呕吐(χ2=6.732, P=0.009)、视物模糊(χ2=5.930, P=0.015)、睡眠障碍(χ2=5.495, P=0.019)、指端麻木(χ2=5.585, P=0.018)、肝功能损害(χ2=4.427，P =0.035)差异有统计学意义，2 组抗结核有效率(χ2=0.180,P =0.671)无显著差异。结论维持性血液透析患者合并肺结核较普通人群肺结核患者相比临床症状无明显差异，治疗过程中不良反应率高，住院周期长，但抗结核治疗仍是有效的。

【Abstract】Objective To compare the clinical characteristics of pulmonary tuberculosis in maintenance hemodialysis (MHD) patients and in general population. Methods A total of 78 MHD patients complicated with pulmonary tuberculosis admitted to The Sixth People's Hospital of Zhengzhou from January 2017 to May 2019 were retrospectively reviewed as the observation group; a total of 110 pulmonary tuberculosis patients admitted to this hospital in the same period were recruited as the control group. Clinical data were compared between the two groups. Results The clinical symptoms of cough and expectoration (χ2=0.282, P=
0.595), fever (χ2=1.709, P=0.091), night sweating (χ2=1.489, P=0.222), hemoptysis (χ2=0.656, P=0.418), chest stuffy and chest pain (χ2=1.472, P=0.232) and fatigue (χ2=1.374, P=0.241) were similar between the two groups of patients. The laboratory tests of positive tuberculosis antibody rate (χ2=3.910, P=0.048), positive TSPORT rate (χ2=4.034, P=0.045), erythrocyte sedimentation rate (χ2=5.691, P=0.017), rate of acid-fast bacilli in sputum smear (χ2=3.910, P=0.048) and lesion ≥3 lobes (χ2=4.201, P=0.040) were statistically significant between the two groups of patients. The effectiveness of anti- tuberculosis drugs was similar between the two groups of patients (χ2=0.180, P=0.671); however, the adverse reactions of nausea and vomiting (χ2=6.732, P=0.009), blurred vision (χ2=5.930, P=0.015), sleep disturbance (χ2=5.495, P=0.019), finger numbness (χ2=5.585, P=0.018) and liver function impairment (χ2=4.427,P=0.035) were different between the two groups of patients. Conclusion The clinical characteristics and the effectiveness of anti-tuberculosis drugs were similar in MHD patients complicated with pulmonary tuberculosis and in pulmonary tuberculosis patients in general population. However, the rates of adverse reactions to anti-tuberculosis drugs were higher and the hospitalization period was longer in MHD patients with pulmonary tuberculosis.