Department of Internal Medicine, Yong-in Severance Hospital, Yonsei University College of Medicine, Yong-in, Republic of Korea.
Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Respirology. 2018 Jan;23(1):100-106. doi: 10.1111/resp.13147. Epub 2017 Aug 27.
Although an association between pulmonary tuberculosis (TB) and chronic obstructive pulmonary disease (COPD) has been suggested, studies on the effect of TB in COPD patients have not been conducted. We aimed to investigate the severity and clinical outcomes of COPD in patients with and without a history of TB.
We retrospectively reviewed the data of 1784 patients with COPD in the Korean COPD Subtype Study cohort collected from December 2011 to January 2017 and followed up for 3 years.
Among the 1784 patients at baseline, the COPD assessment test (CAT) scores and total St George's Respiratory Questionnaire for COPD (SGRQc) scores were significantly higher in the prior TB group (n = 468) than in the non-TB group (n = 1316). Lung function and exacerbation prevalence were significantly poorer and higher, respectively, in the prior TB group than in the non-TB group. In a small-sized follow-up study, CAT scores (n = 318), SGRQc scores (n = 295) and lung function (n = 182) remained poorer, and exacerbation prevalence (n = 256) remained higher in the prior TB group over 3 years. The forced expiratory volume in 1 s in the prior TB group declined (-0.57%/year), whereas it improved (+0.93%/year) in the non-TB group (P for changes between the groups = 0.076). In the prior TB group, patients showed poorer lung function compared with the non-TB group regardless of having lung lesions visible or not on chest radiographs.
TB history negatively affected the severity of COPD, and a small-sized follow-up study showed that the changes were sustained for several years.
虽然已经有人提出肺结核（TB）与慢性阻塞性肺疾病（COPD）之间存在关联，但针对 TB 对 COPD 患者影响的研究尚未开展。我们旨在调查有和无 TB 病史的 COPD 患者的 COPD 严重程度和临床结局。
我们回顾性分析了 2011 年 12 月至 2017 年 1 月期间韩国 COPD 亚型研究队列中纳入的 1784 例 COPD 患者的数据，这些患者随访了 3 年。
在基线时的 1784 例患者中，既往 TB 组（n=468）的 COPD 评估测试（CAT）评分和总圣乔治呼吸问卷 COPD 评分（SGRQc）评分明显高于非 TB 组（n=1316）。既往 TB 组的肺功能和加重发作频率分别明显较差和较高。在一项小规模的随访研究中，CAT 评分（n=318）、SGRQc 评分（n=295）和肺功能（n=182）在 3 年内仍较差，而在既往 TB 组中，加重发作频率（n=256）仍较高。既往 TB 组的 1 秒用力呼气量（FEV1）下降（每年-0.57%），而非 TB 组则改善（每年+0.93%）（两组间变化的 P 值=0.076）。在既往 TB 组中，无论胸部 X 线片上是否可见肺部病变，患者的肺功能均较非 TB 组差。
TB 病史对 COPD 的严重程度有负面影响，一项小规模的随访研究表明，这种变化可持续数年。
