Park Hyeyoung, Cha Seung-Ick, Lim Jae-Kwang, Nyeo Jeon Kyung, Yoo Seung-Soo, Lee Jaehee, Lee Shin-Yup, Kim Chang-Ho, Park Jae-Yong
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
Am J Med Sci. 2017 Feb;353(2):166-171. doi: 10.1016/j.amjms.2016.11.025. Epub 2016 Nov 18.
Data regarding coexisting pulmonary thromboembolism (PTE) in patients with tuberculosis are limited. The aim of this study was to investigate the clinical features of coexisting PTE in patients with respiratory tuberculosis.
Clinical parameters were retrospectively compared between the tuberculosis group (PTE and coexisting respiratory tuberculosis) and unprovoked or provoked group selected from a single institution in South Korea, a country that has an intermediate tuberculosis burden.
Twenty-four patients with PTE and concomitant respiratory tuberculosis were identified. These patients accounted for 1.0% of 2,386 patients with respiratory tuberculosis and 2.8% of 867 PTE patients who were enrolled over the same period. Compared with the unprovoked group, the tuberculosis group had significantly lower body mass index, higher levels of blood inflammatory markers and higher pulmonary embolism severity index (PESI) with a higher incidence of high PESI class (≥3). The tuberculosis group had a significantly lower incidence of central PTE than the unprovoked group, but the rate of right ventricular dilation on computed tomography scan was not significantly different between the 2 groups. Adverse outcomes, PTE-related in-hospital mortality and the recurrence of venous thromboembolism were not significantly different between the tuberculosis and unprovoked or provoked group.
The coexistence of PTE and respiratory tuberculosis rarely occurred in clinical practice. Compared with unprovoked PTE, PTE with respiratory tuberculosis is characterized by lower body mass index, higher levels of blood inflammatory markers, higher PESI and less frequent central PTE, but it is not associated with any differences in outcomes caused by PTE.
关于结核病患者合并肺血栓栓塞症（PTE）的数据有限。本研究旨在调查呼吸道结核病患者合并PTE的临床特征。
回顾性比较结核病组（PTE合并呼吸道结核病）与来自韩国一个结核病负担中等的单一机构中选取的不明原因或有诱因组的临床参数。
确定了24例PTE合并呼吸道结核病患者。这些患者占同期纳入的2386例呼吸道结核病患者的1.0%，以及867例PTE患者的2.8%。与不明原因组相比，结核病组的体重指数显著更低，血液炎症标志物水平更高，肺栓塞严重程度指数（PESI）更高，且高PESI分级（≥3）的发生率更高。结核病组中心型PTE的发生率显著低于不明原因组，但两组间计算机断层扫描的右心室扩张率无显著差异。结核病组与不明原因或有诱因组之间，不良结局、PTE相关的院内死亡率和静脉血栓栓塞复发率无显著差异。
PTE与呼吸道结核病在临床实践中很少共存。与不明原因的PTE相比，合并呼吸道结核病的PTE的特征为体重指数更低、血液炎症标志物水平更高、PESI更高且中心型PTE更少见，但与PTE导致的结局差异无关。
