摘要目的:探讨结核性腹膜炎(Tuberculous peritonitis，TBP)的临床特征。方法:回顾性分析芜湖地区三家医院2014年1月至2020年6月收治的252例TBP患者的临床资料，比较不同性别和年龄TBP患者的临床特征。采用SPSS 26.0软件对数据进行统计分析。结果:252例TBP患者中，男性130例(51.6%)，女性122例(48.4%)。经腹手术史、腹部/腹壁包块、生殖障碍、生殖器官结核及诊断延迟多见于女性患者( P值均<0.01)，发热、咳嗽/咳痰、肠结核和活动性肺结核多见于男性患者( P值均<0.01)。中老年患者腹水腺苷脱氨酶(ADA)≥35 U/L比例、结核菌素试验或T细胞斑点试验中~强阳率均低于青年患者( P值均<0.01)，但不同性别比较，差异无统计意义。与青年患者相比，中老年患者完全应答率低，不规律用药比例高，胃肠道反应、肝功能损伤及整体不良反应发生率高( P值均<0.05)。 结论:女性TBP患者全身结核症状偏少，诊断延迟率高，易合并生殖结核；中老年TBP患者腹水ADA及结核特征性检测的灵敏度下降，抗结核效果不理想，应结合患者的性别和年龄因素优化TBP临床诊疗。

abstractsObjective:To analyze the clinical features of tuberculous peritonitis (TBP).Methods:The clinical data of 252 TBP patients admitted to three hospitals in Wuhu area from January 2014 to June 2020 were retrospectively analyzed, and the clinical characteristics of TBP patients of different genders and ages were compared. SPSS 26.0 software was used to analyze the data.Results:Among 252 TBP patients, 130 were males (51.6%) and 122 were females (48.4%). History of abdominal surgery, abdominal masses, reproductive disorders, genital tuberculosis, and delay in diagnosis were more common in female patients (all P<0.01); while fever, cough/sputum expectoration, intestinal tuberculosis and active tuberculosis were more common in male patients (all P<0.01). The proportion of adenosine deaminase in ascites (ADA) ≥35 U/L, strong positive tuberculin test or T-cell spot test in middle-aged and elderly patients was lower than that in young patients ( P<0.01), but there was no significant difference between different genders. Compared with young patients, middle-aged and elderly patients had a low complete response rate, a high proportion of irregular medications, a high incidence of gastrointestinal reactions, liver damage and overall adverse reactions (all P<0.05). Conclusion:Female patients with TBP have fewer symptoms of systemic tuberculosis and high rate of delay in diagnosis, and are prone to complicated with reproductive tuberculosis. In middle-aged and elderly patients with TBP, the sensitivity of ADA and tuberculosis tests is decreased, and the anti-tuberculosis therapy is less effective. The study indicates that the clinical diagnosis and treatment of TBP should be optimized based on the gender and age of patients.