Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
J Korean Med Sci. 2011 Feb;26(2):268-73. doi: 10.3346/jkms.2011.26.2.268. Epub 2011 Jan 24.
We evaluated the effects of previous pulmonary tuberculosis (TB) on the risk of obstructive lung disease. We analyzed population-based, the Second Korea National Health and Nutrition Examination Survey 2001. Participants underwent chest X-rays (CXR) and spirometry, and qualified radiologists interpreted the presence of TB lesion independently. A total of 3,687 underwent acceptable spirometry and CXR. Two hundreds and ninety four subjects had evidence of previous TB on CXR with no subjects having evidence of active disease. Evidence of previous TB on CXR were independently associated with airflow obstruction (adjusted odds ratios [OR] = 2.56 [95% CI 1.84-3.56]) after adjustment for sex, age and smoking history. Previous TB was still a risk factor (adjusted OR = 3.13 [95% CI 1.86-5.29]) with exclusion of ever smokers or subjects with advanced lesion on CXR. Among never-smokers, the proportion of subjects with previous TB on CXR increased as obstructive lung disease became more severe. Previous TB is an independent risk factor for obstructive lung disease, even if the lesion is minimal and TB can be an important cause of obstructive lung disease in never-smokers. Effort on prevention and control of TB is crucial in reduction of obstructive lung disease, especially in countries with more than intermediate burden of TB.
我们评估了既往肺结核（TB）对阻塞性肺疾病风险的影响。我们分析了基于人群的韩国第二次国家健康和营养调查 2001 年的数据。参与者接受了胸部 X 光（CXR）和肺功能检查，合格的放射科医生独立解读 TB 病变的存在。共有 3687 人进行了可接受的肺功能检查和 CXR。294 名患者的 CXR 有既往 TB 的证据，无活动性疾病的证据。在调整性别、年龄和吸烟史后，CXR 上既往 TB 的证据与气流阻塞独立相关（校正比值比[OR] = 2.56 [95% CI 1.84-3.56]）。既往 TB 仍然是一个危险因素（校正 OR = 3.13 [95% CI 1.86-5.29]），排除了既往吸烟者或 CXR 上有晚期病变的患者。在从不吸烟者中，CXR 上既往 TB 的患者比例随着阻塞性肺疾病的严重程度增加而增加。既往 TB 是阻塞性肺疾病的一个独立危险因素，即使病变最小，TB 也可能是从不吸烟者阻塞性肺疾病的一个重要原因。在结核病负担较重的国家，努力预防和控制结核病对于减少阻塞性肺疾病至关重要。
