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Objective To explore the clinical characteristics and prognosis of patients with end-stage renal disease (ESRD)in maintenance hemodialysis (MHD) and complicated with pathogen-positive and -negative pulmonary tuberculosis. Methods A total of 98 ESRD patients complicated with pulmonary tuberculosis, admitted in the Tuberculosis Department and undergone MHD at the Blood Purification Center of the 8th Medical Center of PLA General Hospital from July 2012 to February 2022, were collected,and divided into pathogen-positive group (n=34) and pathogen-negative group (n=64) according to the results of sputum smear, sputum culture of Mycobacterium tuberculosis and molecular biological diagnosis. The clinical characteristics, therapeutic effect and prognosis of the two groups were compared and analyzed. Results Both the pathogen-positive and -negative pulmonary tuberculosis groups were mainly the males (85.3% and 76.6%, respectively) and middle-aged and elderly people [(56.4±15.6) years old and (55.8±15.0) years old, respectively]. The proportion of patients with non-primary glomerulonephritis as main underlying kidney disease, and with cough and sputum as the first manifested symptom, were both higher in pathogen-positive group than in pathogen-negative group (38.2% vs. 17.2% and 91.2% vs. 50.0%, respectively) (P<0.05). The laboratory results showed that the leukocyte, neutrophil, monocyte count,neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR) and C-reactive protein level were higher, while the lymphocyte count was lower in pathogen-positive group than in pathogen-negative group (P<0.05). The chest CT found that the proportion of pleural thickened and cavity formation was higher (P<0.05), while of strip shadow was lower (P<0.05) in pathogen-positive group than in pathogen-negative group. The efficacy of anti-tuberculosis treatment was better in the both groups (94.1% vs. 95.3%). Multivariate logistic regression analysis found that cough and sputum (OR=12.572, 95%CI 2.609-60.581), MLR (OR=8.226, 95%CI 2.479-27.298),pleural thickening (OR=4.740, 95%CI 1.043-21.541) and cavitation (OR=8.462, 95%CI 2.423-29.555) were the risk factors for patients complicated with pathogen-positive pulmonary tuberculosis. Conclusions Significant differences of clinical characteristics existed between the pathogen-positive and -negative tuberculosis patients with ESRD on MHD. Cough and sputum as the first symptom, MLR,pleural thickening and cavitation are the risk factors for the pathogen-positive tuberculosis.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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