Analysis on the clinical characteristics and process of diagnosis and treatment of patients with pulmonary tuberculosis after liver transplantation
Objective To explore the clinical principles of diagnosis and treatment for patients with pulmonary tuberculosis after liver transplantation.Methods The inpatients treated in Guangzhou Chest Hospital from January 2014 to December 2023 were collected,and the data or information related to the clinical symptoms,lesion location involved,duration of diagnosis,number of hospitalizations,length of hospital stay each time,and clinical therapeutic effect of 25 inpatients with pulmonary tuberculosis after liver transplantation(study group)and 31 inpatients with pulmonary tuberculosis but non-organ transplantation(control group)were comparatively analyzed.Among them,there were 55 males and 1 female,ranging in age from 1 to 75 years old,with an average age of 66 years old.x2 test and rank sum test were used for statistical methods.Results The rates of fever and fatigue and emaciation in the study group were higher than those in the control group[68.0％(17/25)vs.22.6％(7/31),56.0％(14/25)vs.29.0％(9/31)],with statistically significant differences(x2=11.66 and 4.16,both P＜0.05).There were no statistically significant differences between the two groups in the incidences of tuberculosis lesions in thorax and lung(including lung lobes,bronchus,and pleura)and cavity lesions under CT images,but the incidence of extra-pulmonary tuberculosis(lower extremities,abdominal cavity,neck,brain,lumbar vertebra,testis,etc.)in the study group was higher than that in the control group[44.0％(11/25)vs.3.2％(1/31)],with a statistically significant difference(x2=13.67,P＜0.05).The onset time of tuberculosis in the study group ranged from 3 to 240 months after liver transplantation(P25,P50,and P75 were 24,40,and 75 months,respectively),and there was no statistically significant difference in the duration of tuberculosis diagnosis or length of hospital stay each time between the two groups(both P＞0.05).In the study group,4 patients died due to advanced tumor,1 patient had not yet completed the course of treatment by December 2023,but the condition was significantly improved,and the other 20 patients were cured after anti-tuberculosis treatment for 12 to 36 months(P25,P50,and P75 were 14,15,and 18 months,respectively).In the control group,1 patient died due to advanced lung cancer,and the other 30 patients were cured after anti-tuberculosis treatment for 6 to 18 months(P25,P50,and P75 were 12,12,and 14 months,respectively).The length of anti-tuberculosis therapy course of the study group was longer than that of the control group(Z=3.54,P＜0.05).The percent of above 3 times hospitalizations were 20.00％(5/25)in the study group,which was higher than 6.45％(2/31)in the control group(x2=42.83,P＜0.05).Conclusions It is essential to pay close attention to extrapulmonary tuberculosis,complicated disease changes,and long anti-tuberculosis therapy course in patients with pulmonary tuberculosis after liver transplantation.
Liver transplantationTuberculosis/pulmonaryClinical features
万方数据
维普
