目的观察老年性肺结核的临床特点。方法对2003年1月～2008年12月所收治86例老年肺结核病例进行回顾性调查分析,分析其基础疾病、起病及临床特征等。结果老年肺结核患者病情重、症状不典型、X线表现不典型、具有四多一差(因症就诊多、合并症多、误诊者多、复发者多、治疗效果差)等现象。结论各级综合医院医师,应熟悉肺结核的早期非特异性症状,对具有肺部疾患出现原因不明的发热、咳嗽、咯血、食欲减退、呼吸困难为主要症状者应高度警惕肺结核存在的可能性,正确运用辅助检查,重视X线胸片、痰菌检查手段,做到早期发现病人。对接受抗痨治疗的病人,注重规范化治疗与个体化治疗相结合的原则,积极治疗肺部感染、糖尿病等合并症,定期复查肝功能,避免和减少毒副反应发生。 Objective To observe the clinical features of senile pulmonary tuberculosis. Methods A retrospective survey of 86 cases of elderly pulmonary tuberculosis admitted from January 2003 to December 2008 was conducted to analyze the underlying diseases, their onset and clinical features. Results Elderly patients with pulmonary tuberculosis were severely ill, the symptoms were not typical, and the X-ray findings were not typical. They had more than four differences (many were treated due to illness, many were complicated, many were misdiagnosed, many were relapsed, and the treatment was poor). Conclusions General hospital physicians at all levels should be familiar with the early nonspecific symptoms of pulmonary tuberculosis. Those who have the unexplained fever, cough, hemoptysis, loss of appetite and dyspnea as the main symptoms of pulmonary diseases should be highly alert to the possibility of pulmonary tuberculosis, and correct Use of auxiliary examination, emphasis on X-ray, sputum examination means to achieve early detection of patients. For patients receiving anti-tuberculosis treatment, pay attention to the principle of combination of standardized treatment and individualized treatment, active treatment of complications such as pulmonary infection and diabetes, regular review of liver function, to avoid and reduce side effects.