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治疗结束时肺部耐多药结核病的后遗症。

Sequelae of pulmonary multidrug-resistant tuberculosis at the completion of treatment.

作者信息

Singla Rupak, Mallick Manashree, Mrigpuri Parul, Singla Neeta, Gupta Amitesh

机构信息

Department of TB and Respiratory Diseases, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India.

Department of Epidemiology, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India.

出版信息

Lung India. 2018 Jan-Feb;35(1):4-8. doi: 10.4103/lungindia.lungindia_269_16.

Abstract

BACKGROUND

Treatment of multidrug-resistant (MDR-TB) mainly focuses on bacteriological cure. However, only limited studies have evaluated the sequelae left after the completion of treatment among MDR-TB patients.

OBJECTIVE

To assess the persistent symptoms, radiological sequelae, pulmonary function impairment and quality of life at the completion of treatment among MDR-TB patients.

METHODS

Forty six MDR-TB patients were enrolled, who completed two years of treatment under programmatic management of Drug Resistant tuberculosis at a tertiary referral institute in Delhi, India. Detailed clinical history was taken. X-ray chest, 6 Minute Walk Test and pulmonary function tests were attempted in all patients. Quality of life was evaluated using Seattle obstructive lung disease questionnaire.

RESULTS

At the completion of MDR-TB treatment 95.7% patients had residual symptoms; 100% patients had residual bilateral chest x-ray abnormality with 82.6% patients showing far advanced disease. PFT was abnormal in 97.6% patients with mixed pattern being the commonest abnormality. Quality of Life was impaired with mean physical function of 46%.

CONCLUSION

At the completion of MDR-TB treatment, significant numbers of patients are left with post treatment sequelae. The medical management and social support for these patients should be incorporated in the national programs.

摘要

背景

耐多药结核病(MDR-TB)的治疗主要侧重于细菌学治愈。然而,仅有有限的研究评估了耐多药结核病患者完成治疗后留下的后遗症。

目的

评估耐多药结核病患者完成治疗时的持续症状、放射学后遗症、肺功能损害及生活质量。

方法

纳入46例耐多药结核病患者,他们在印度德里一家三级转诊机构的耐药结核病规划管理下完成了两年的治疗。记录详细的临床病史。对所有患者进行胸部X线检查、6分钟步行试验和肺功能测试。使用西雅图阻塞性肺疾病问卷评估生活质量。

结果

耐多药结核病治疗结束时,95.7%的患者有残留症状;100%的患者胸部X线检查有双侧残留异常,82.6%的患者显示病情严重。97.6%的患者肺功能测试异常,最常见的异常类型为混合型。生活质量受损,平均身体功能为46%。

结论

耐多药结核病治疗结束时,大量患者有治疗后后遗症。这些患者的医疗管理和社会支持应纳入国家计划。

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