目的　探讨造成空洞性肺结核误诊的因素。方法　收集该院最后确诊为空洞性肺结核患者 2 66例 ,根据入院诊断分为确诊组 ( 2 3 9例 )和误诊组 ( 2 7例 ) ,并进行各种有关因素的比较分析及Logistic回归分析。结果　误诊组在咳嗽、气促、发热、胸痛 4个主要临床症状的出现明显高于确诊组 ,而肺结核史却明显低于确诊组。胸部X线透视发现有类似空洞的阴影者 ,误诊组也明显高于确诊组。应用多元Logistic回归分析表明 ,最后进入模型的有气促、发热和胸痛。结论　最容易导致将空洞性肺结核误诊为肺脓肿、脓肿并胸膜瘘、肺囊肿或其他诊断的因素是气促 (危险度为 13 .81)、发热(危险度 9.82 )、胸痛 (危险度 8.2 1)。其次 ,痰找抗酸杆菌、肺结核史或接触史也是值得重视的因素 Objective To investigate the causes of misdiagnosis of empty tuberculosis. Methods Totally 666 patients with empty tuberculosis were collected from the hospital. According to the diagnosis, they were divided into definite diagnosis group (2393 cases) and misdiagnosis group (27 cases), and comparative analysis of various factors and Logistic regression analysis . Results The misdiagnosis group had significantly higher incidence of cough, shortness of breath, fever and chest pain than the diagnosed group, but the history of pulmonary tuberculosis was significantly lower than that of the diagnosed group. Chest X-ray findings were similar to the shadow of the hole, the misdiagnosis group was significantly higher than the diagnosed group. Multiple logistic regression analysis showed that the last entered the model of irritation, fever and chest pain. Conclusions The most likely causes of misdiagnosis of pulmonary tuberculosis as pulmonary abscess, abscess with pleural fistula, pulmonary cyst or other diagnostic factors are shortness of breath (hazard ratio: 13.81), fever (hazard ratio: 9.82), chest pain (hazard ratio: 8.21 ). Second, find sputum acid-fast bacilli, tuberculosis history or exposure history is also worthy of attention