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肺功能对结核病患者治疗结局的影响。

Impact of lung function on treatment outcome in patients with TB.

机构信息

Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany, German Centre for Infection Research (DZIF), Partner site Hamburg-Lübeck-Borstel-Riems, Germany.

Kharkiv National Medical University, Kharkiv, Ukraine.

出版信息

Int J Tuberc Lung Dis. 2021 Apr 1;25(4):277-284. doi: 10.5588/ijtld.20.0949.

Abstract

The potential association between the lung function status at baseline and TB treatment outcome has not been evaluated previously. We aimed to investigate the impact of lung function status at the time of TB diagnosis on treatment outcome in patients with pulmonary TB (PTB). A retrospective cohort study on data from all consecutive patients with culture-confirmed PTB and available spirometry test results admitted during the year 2016 to the Regional anti-TB dispensary no.1 in Kharkiv, Ukraine. A total of 278 patients with PTB were included into the study. The rate of negative treatment outcome (failure or death) was higher in patients with restrictive and mixed lung dysfunction than in those with normal spirometry results (25.6% vs. 6.8%, = 0.0007; 37.5% vs. 6.8%, = 0.003, respectively). In a logistic regression model, restrictive lung disease and mixed-type lung disease were associated with negative treatment outcome (OR 4.19, 95% CI 1.60-13.28, = 0.007 and OR 5.46, 95% CI 1.28-24.44, = 0.02, respectively). Lung function at the time of diagnosis has an important impact on treatment outcomes in patients with PTB; the more severe the restriction in lung function the higher the likelihood of a negative treatment outcome.

摘要

先前尚未评估基线时的肺功能状况与结核病治疗结局之间的潜在关联。我们旨在研究结核病诊断时的肺功能状况对肺结核(PTB)患者治疗结局的影响。这是一项回顾性队列研究,对 2016 年乌克兰哈尔科夫第 1 区域抗结核门诊部连续收治的所有经培养确诊的 PTB 患者及可获得的肺量计检测结果进行了数据分析。共有 278 例 PTB 患者纳入研究。与肺量计检测结果正常的患者相比,存在限制性和混合性肺功能障碍的患者的治疗结局(失败或死亡)的发生率更高(25.6%比 6.8%, = 0.0007;37.5%比 6.8%, = 0.003)。在逻辑回归模型中,限制性肺病和混合性肺病与不良治疗结局相关(OR 4.19,95%CI 1.60-13.28, = 0.007 和 OR 5.46,95%CI 1.28-24.44, = 0.02)。诊断时的肺功能对 PTB 患者的治疗结局有重要影响;肺功能受限越严重,治疗结局不良的可能性越高。

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