透析患者の結核症 : 第1報肺, 肺外および両者合併病巣を有する結核症の致命率

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An epidemiological study was made in the fatality of tuberculosis in order to clarify the severity of three different types of tuberculosis in dialysis patients.<BR>Study subjects were 7, 274 dialysis patients including 150 tuberculosis treated in 161 institutions throughout Japan. Among 150 tuberculosis patients, the sites of involvement were documented in 137 cases.<BR>The fatality was 15.5% in 58 tuberculosis cases with solely pulmonary lesions. It was as high as 44.4% in 27 cases with pulmonary tuberculosis complicated with extrapulmonary lesions, while it was 9.6% in 52 cases with solely extrapulmonary lesions. Organs frequently involved not only among patients with combined pulmonary and extrapulmonary involvements, but also among patients died of all three types of tuberculosis were liver, spleen, bone marrow, pancreas, trachea and adrenal gland, etc. These organs were rarely involved among tuberculosis patients survived and in the past history of tuberculosis of dialysis patients. Another group of organs were kidney, urinary tract, pleura, mesenterium and bone and joint. They were involved in the past episode of tuberculosis and were frequently seen in the survivers of all three types of tuberculosis as well as in patients with solely extrapulmonary lesions. When the former group of organs were involved, tuberculosis process can be evaluated as severer.<BR>Further, the more the number of organs involved, the higher the fatality of tuberculosis. The mean number of organs involved was 3.6 per patient in patients with combined pulmonary and extra pulmonary involvements, while it was 1.2 per patient in patients with solely extrapulmonary lesions, and was naturally 1.0 in patients with solely pulmonary lesions. These facts might be reflected in the high fatality rate of patients with combined pulmonary and extrapulmonary lesions.
日本結核病学会の論文

著者

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慶応義塾大学医学部附属病院中央透析室

透析患者の結核症 : 第1報肺, 肺外および両者合併病巣を有する結核症の致命率

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