Instituto Nacional de Saúde (INS), Maputo, Mozambique.
Center for International Health - CIHLMU, Munich, Germany.
BMC Pulm Med. 2020 May 7;20(1):127. doi: 10.1186/s12890-020-1167-1.
Pulmonary tuberculosis (PTB) is frequently associated with chronic respiratory impairment despite microbiological cure. There are only a few clinical research studies that describe the course, type and severity as well as associated risk factors for lung impairment (LI) in TB patients.
A prospective cohort study was conducted at TB Research Clinic of Instituto Nacional de Saúde in Mavalane, Maputo, from June 2014 to June 2016. PTB patients were prospectively enrolled and followed for 52 weeks after TB diagnosis. Lung function was evaluated by spirometry at 8, 26 and 52 weeks after TB treatment initiation, and spirometric values of below the lower limit of normality were considered as LI. Descriptive statistical analysis was performed to summarize the proportion of patients with different lung outcomes at week 52, including type and severity of LI. Risk factors were analysed using multinomial regression analysis.
A total of 69 PTB patients were enrolled, of which 62 had a valid spirometry result at week 52 after TB treatment start. At week 8, 26 and 52, the proportion of patients with LI was 78, 68.9 and 64.5%, respectively, and 35.5% had moderate or severe LI at week 52. The majority of patients with LI suffered from pulmonary restriction. Female sex, low haemoglobin and heavy smoking were significantly associated with LI.
Moderate or severe LI can be observed in a third of cured TB patients. Further research is urgently needed to gain deeper insight into the characteristics of post TB LI, the causal pathways and potential treatment strategies.
尽管结核分枝杆菌（PTB）已得到微生物学治愈，但仍常伴有慢性呼吸损害。仅有少数临床研究描述了结核病患者肺部损害（LI）的病程、类型和严重程度以及相关的危险因素。
本前瞻性队列研究于 2014 年 6 月至 2016 年 6 月在马普托的莫桑比克国家卫生研究院结核病研究诊所进行。PTB 患者前瞻性入组，并在 TB 诊断后 52 周内进行随访。在 TB 治疗开始后 8、26 和 52 周，通过肺量计评估肺功能，将低于正常值下限的肺量计值定义为 LI。采用描述性统计分析总结第 52 周时不同肺部结局患者的比例，包括 LI 的类型和严重程度。采用多项回归分析评估危险因素。
共纳入 69 例 PTB 患者，其中 62 例在 TB 治疗开始后 52 周时具有有效的肺量计结果。在第 8、26 和 52 周，LI 患者的比例分别为 78%、68.9%和 64.5%，第 52 周时 35.5%的患者有中重度 LI。大多数 LI 患者存在肺部受限。女性、低血红蛋白和重度吸烟与 LI 显著相关。
三分之一治愈的 TB 患者可出现中重度 LI。迫切需要进一步研究以深入了解 TB 后 LI 的特征、因果途径和潜在治疗策略。
