Ko Y, Lee Y-M, Lee H-Y, Lee Y S, Song J-W, Hong G-Y, Kim M-Y, Lee H-K, Choi S J, Shim E-J
Department of Pulmonary and Critical Care Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea; Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Int J Tuberc Lung Dis. 2015 May;19(5):589-95. doi: 10.5588/ijtld.14.0454.
To evaluate changes in lung function in individuals before and after treatment for pulmonary tuberculosis (PTB) in relation to extent of disease.
Using a retrospective cohort design, changes in and predictors of lung function were evaluated.
A total of 41 patients were included in the final analysis. The median decline in annualised forced expiratory volume in 1 sec (FEV1) was 180.0 ml/year (95%CI 118.9-356.1) in advanced PTB and 94.7 ml/year (95%CI 33.4-147.3) in localised PTB (ΔFEV1% predicted/year 9.4%, 95%CI 4.4-14.0 vs. 3.8%, 95%CI 1.8-6.2). The median decline in annualised forced vital capacity (FVC) was 309.6 ml/year (95%CI 137.0-359.0) in advanced PTB and 101.1 ml/year (95%CI 30.3-219.6) in localised PTB (ΔFVC % predicted/year 7.3%, 95%CI 5.3-12.3 vs. 2.9%, 95%CI 0.9-6.5).
As the sample size of our study was small, the conclusions could be biased. Nevertheless, our findings show that PTB causes a significant decline in lung function even in localised PTB, whereas advanced PTB was associated with excessive or even higher decline. This study suggests that early diagnosis and treatment of PTB is needed to preserve lung function.
评估肺结核(PTB)患者治疗前后肺功能的变化及其与疾病程度的关系。
采用回顾性队列设计,评估肺功能的变化及其预测因素。
最终纳入分析的患者共41例。晚期PTB患者1秒用力呼气容积(FEV1)的年化下降中位数为180.0 ml/年(95%CI 118.9 - 356.1),局限性PTB患者为94.7 ml/年(95%CI 33.4 - 147.3)(预测FEV1%/年下降9.4%,95%CI 4.4 - 14.0 vs. 3.8%,95%CI 1.8 - 6.2)。晚期PTB患者用力肺活量(FVC)的年化下降中位数为309.6 ml/年(95%CI 137.0 - 359.0),局限性PTB患者为101.1 ml/年(95%CI 30.3 - 219.6)(预测FVC%/年下降7.3%,95%CI 5.3 - 12.3 vs. 2.9%,95%CI 0.9 - 6.5)。
由于本研究样本量较小,结论可能存在偏差。尽管如此,我们的研究结果表明,即使是局限性PTB,PTB也会导致肺功能显著下降,而晚期PTB则与过度甚至更高的下降相关。本研究提示,需要对PTB进行早期诊断和治疗以保护肺功能。