Swain Smrutirekha, Pothal Sudarsan, Behera Aurobindo, Manjhi Rekha, Dutta Pravati, Pradhan Gourahari
V.S.S. Institute of Medical Sciences & Research, Burla, Odisha, India.
J Family Med Prim Care. 2021 Sep;10(9):3411-3416. doi: 10.4103/jfmpc.jfmpc_2391_20. Epub 2021 Sep 30.
Post Tubercular Obstructive Airways Diseases (Post-TB OAD) is a sequela of Pulmonary TB but diseases progression may not same like Chronic Obstructive Pulmonary Diseases (COPD).
To compare the frequency and severity of exacerbations, change of FEV1, frequency of hospitalization and mortality among COPD and post TB OAD patients.
Hospital-based prospective cohort study.
COPD cohort was diagnosed based on symptoms, history of exposure to risk factors and post bronchodilator FEV1/FVC ratio <70%. Post TB OAD cohort was diagnosed like COPD along with past history of Pulmonary TB. Both cohorts were followed up every 3-monthly intervals for up to 12 months.
Comparison of categorical variable was done by Chi-square test and continuous variable by unpaired t test. Longitudinal data of FEV1% were analyzed by repeated measure ANOVA test.
Totally, 68 patients with Post TB OAD and 66 COPD patients were taken into this study. The frequency of exacerbation (3.52 ± 1.84 verses 2.70 ± 1.37), number of severe exacerbation (56 verses 24) and frequency of hospitalization (1.37 ± 0.81 verses 0.97 ± 0.94) more seen in post-TB OAD cohort in compared to COPD cohort which is statistically significant. Mortality more seen in post-TB OAD group (14 verses 6). Rate of decline FEV1 per year more seen in Post-TB OAD (0.27 ± 0.28 lit verses 0.17 ± 0.26 liter) as compared to COPD. There was overall decreasing trend of FEV1% over period of 12 month but without any difference among two cohort.
There was more in frequency of exacerbations, number of severe exacerbations, frequency of hospitalization and number of mortalities among post TB OAD compared to COPD.
结核后阻塞性气道疾病（Post-TB OAD）是肺结核的后遗症，但疾病进展可能与慢性阻塞性肺疾病（COPD）不同。
比较慢性阻塞性肺疾病（COPD）和结核后阻塞性气道疾病（Post-TB OAD）患者急性加重的频率和严重程度、第一秒用力呼气容积（FEV1）的变化、住院频率和死亡率。
基于医院的前瞻性队列研究。
COPD队列根据症状、危险因素暴露史和支气管扩张剂使用后FEV1/FVC比值<70%进行诊断。结核后阻塞性气道疾病（Post-TB OAD）队列除了有肺结核病史外，诊断方法与COPD相同。两个队列均每3个月随访一次，为期12个月。
分类变量采用卡方检验进行比较，连续变量采用非配对t检验进行比较。FEV1%的纵向数据采用重复测量方差分析进行分析。
本研究共纳入68例结核后阻塞性气道疾病（Post-TB OAD）患者和66例COPD患者。与COPD队列相比，结核后阻塞性气道疾病（Post-TB OAD）队列的急性加重频率（3.52±1.84对2.70±1.37）、严重急性加重次数（56对24）和住院频率（1.37±0.81对0.97±0.94）更高，差异具有统计学意义。结核后阻塞性气道疾病（Post-TB OAD）组的死亡率更高（14对6）。与COPD相比，结核后阻塞性气道疾病（Post-TB OAD）每年FEV1下降率更高（0.27±0.28升对0.17±0.26升）。在12个月期间，FEV1%总体呈下降趋势，但两个队列之间无差异。
与COPD相比，结核后阻塞性气道疾病（Post-TB OAD）的急性加重频率、严重急性加重次数、住院频率和死亡人数更多。
