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肺结核损毁肺患者的临床特征。

Clinical characteristics of patients with tuberculosis-destroyed lung.

机构信息

Department of Internal Medicine, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Korea.

出版信息

Int J Tuberc Lung Dis. 2013 Jan;17(1):67-75. doi: 10.5588/ijtld.12.0351.

Abstract

SETTING

Multicentre study.

OBJECTIVE

To define the clinical characteristics of patients with tuberculosis (TB) destroyed lung due to past TB.

DESIGN

We reviewed patients with TB-destroyed lung between May 2005 and June 2011.

RESULTS

A total of 595 patients from 21 hospitals were enrolled. The mean age was 65.63 ± 0.47 (mean ± standard error); 60.5% were male. The mean number of lobes involved was 2.59 ± 0.05. Pleural thickening was observed in 54.1% of the patients. Mean forced vital capacity (FVC), forced expiratory volume in 1 s (FEV(1)), FEV(1)/FVC, bronchodilator response and number of exacerbations per year were respectively 2.06 ± 0.03 l (61.26% ± 0.79), 1.16 ± 0.02 l (49.05% ± 0.84), 58.03% ± 0.70, 5.70% ± 0.34, and 0.40 ± 0.04. The number of lobes involved was significantly correlated with FVC and FEV(1), and with the number of exacerbations per year. Use of long-acting muscarinic antagonists or long-acting beta-2 agonists plus inhaled corticosteroids resulted in bronchodilatory effects. Multivariable regression analysis showed that age, initial FEV(1) (%) and number of exacerbations during follow-up were independent factors affecting change in FEV(1).

CONCLUSION

Decreased lung function with exacerbation, and progressive decline of FEV(1) were observed in patients with TB-destroyed lung.

摘要

背景

多中心研究。

目的

明确既往肺结核导致损毁肺患者的临床特征。

设计

我们回顾了 2005 年 5 月至 2011 年 6 月间患有损毁肺肺结核的患者。

结果

共有来自 21 家医院的 595 名患者入选。平均年龄为 65.63 ± 0.47(均值 ± 标准误),60.5%为男性。平均累及肺叶数为 2.59 ± 0.05。54.1%的患者存在胸膜增厚。用力肺活量(FVC)、1 秒用力呼气容积(FEV1)、FEV1/FVC、支气管扩张剂反应和每年急性加重次数的平均值分别为 2.06 ± 0.03 l(61.26% ± 0.79)、1.16 ± 0.02 l(49.05% ± 0.84)、58.03% ± 0.70、5.70% ± 0.34 和 0.40 ± 0.04。累及肺叶数与 FVC 和 FEV1 显著相关,也与每年急性加重次数相关。长效抗胆碱能药物或长效β2 激动剂联合吸入皮质激素的使用可产生支气管扩张作用。多变量回归分析显示,年龄、初始 FEV1(%)和随访期间急性加重次数是影响 FEV1 变化的独立因素。

结论

损毁肺肺结核患者肺功能下降伴急性加重,FEV1 呈进行性下降。

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