关键词: 结核, 气管/诊断

Abstract: Objective To investigate the clinical characteristics of bacteriologically-negative tracheobronchial tuberculosis (TBTB). Methods A retrospective study was conducted to analyze the clinical features of 70 bacteriologically-negative tracheobronchial TB patients registered in Guangzhou Chest Hospital from July 2006 to June 2012, who had completed medical records and their diagnosis were pathologically confirmed. At the same time, 97 bacteriologically-positive tracheobronchial TB patients registered in the same hospital and in the same period were rando-mized enrolled as a control group. The following clinical characteristics were compared between 2 groups: clinical symptoms, imaging, signs and bronchoscopic features; Chi-square test was used for statistics analysis (P<0.05 was considered statistically significant). Results (1) In the bacteriologically-negative tracheobronchial TB group, the proportion of patients with dry rales detected by lung auscultation was 51.43% (36/70), which was higher than the rate in the bacteriologically-positive group (34.02%, 33/97). A significant difference was showed between 2 groups (χ²=5.082, P<0.05); The proportion of patients with moist rales was lower in the bacteriologically-negative group (15.71%, 11/70) than that in the bacteriologically-positive group (32.99%,32/97). It also showed a significant difference between 2 groups (χ²=6.347, P<0.05). (2) The main bronchoscopic features of the bacteriologically-negative tracheobronchial TB patients were inflammatory infiltration (type Ⅰ, 40.00%, 28/70) and scar stenosis (type Ⅳ, 52.86%, 37/70), which were significantly higher than the rates of type Ⅰ (23.71%, 23/97) and type Ⅳ (19.59%, 19/97) among bacteriologically-positive patients (χ²=45.817, P<0.01).   Conclusion Tracheobronchial TB with bacteriologically-negative is lack of specific clinical symptoms and imaging, its bronchoscopic features are mainly inflammatory infiltration (type Ⅰ) and scar stenosis (type Ⅳ). We should keep alert to tracheobronchial TB when the decreased breath sounds or dry rales are detected by auscultation.