Menezes A M B, Hallal P C, Perez-Padilla R, Jardim J R B, Muiño A, Lopez M V, Valdivia G, Montes de Oca M, Talamo C, Pertuze J, Victora C G
Federal University of Pelotas, Pelotas, Brazil.
Eur Respir J. 2007 Dec;30(6):1180-5. doi: 10.1183/09031936.00083507. Epub 2007 Sep 5.
The aim of the present study was to evaluate the association between history of tuberculosis and airflow obstruction. A population-based, multicentre study was carried out and included 5,571 subjects aged > or =40 yrs living in one of five Latin American metropolitan areas: Sao Paulo (Brazil); Montevideo (Uruguay); Mexico City (Mexico); Santiago (Chile); and Caracas (Venezuela). Subjects performed pre- and post-bronchodilator spirometry and were asked whether they had ever been diagnosed with tuberculosis by a physician. The overall prevalence of airflow obstruction (forced expiratory volume in one second/forced vital capacity post-bronchodilator <0.7) was 30.7% among those with a history of tuberculosis, compared with 13.9% among those without a history. Males with a medical history of tuberculosis were 4.1 times more likely to present airflow obstruction than those without such a diagnosis. This remained unchanged after adjustment for confounding by age, sex, schooling, ethnicity, smoking, exposure to dust and smoke, respiratory morbidity in childhood and current morbidity. Among females, the unadjusted and adjusted odds ratios were 2.3 and 1.7, respectively. In conclusion, history of tuberculosis is associated with airflow obstruction in Latin American middle-aged and older adults.
本研究的目的是评估结核病病史与气流阻塞之间的关联。开展了一项基于人群的多中心研究，纳入了居住在拉丁美洲五个大都市地区之一的5571名年龄≥40岁的受试者，这些地区分别是：圣保罗（巴西）；蒙得维的亚（乌拉圭）；墨西哥城（墨西哥）；圣地亚哥（智利）；以及加拉加斯（委内瑞拉）。受试者进行了支气管扩张剂使用前后的肺功能测定，并被问及是否曾被医生诊断为结核病。有结核病病史者中气流阻塞（支气管扩张剂使用后一秒用力呼气量/用力肺活量<0.7）的总体患病率为30.7%，而无结核病病史者为13.9%。有结核病病史的男性出现气流阻塞的可能性是未诊断出该病者的4.1倍。在对年龄、性别、受教育程度、种族、吸烟、接触灰尘和烟雾、儿童期呼吸系统疾病及当前疾病等混杂因素进行校正后，这一情况保持不变。在女性中，未校正和校正后的比值比分别为2.3和1.7。总之，在拉丁美洲的中老年人群中，结核病病史与气流阻塞有关。
