Department of Respiratory and Critical Care Medicine, 26674Changi General Hospital, Singapore, Singapore.
Respiratory Medicine, Raffles Specialist Centre, Singapore, Singapore.
Chron Respir Dis. 2022 Jan-Dec;19:14799731221098714. doi: 10.1177/14799731221098714.
Bronchiectasis is a heterogeneous disease with distinct phenotypes. The post-tuberculosis (post-TB) bronchiectasis phenotype is prevalent in many countries but is under-studied. Our aim was to identify distinct phenotypic characteristics of post-TB bronchiectasis.
We recruited adults admitted between Jan 2010-Oct 2017 at Changi General Hospital, Singapore for bronchiectasis exacerbation. We collected demographics, symptoms, lung function, microbiology and FACED scores. Participants were followed-up until the next hospitalized exacerbation or end of study, whichever was sooner. Participants diagnosed by their attending respiratory specialist to have post-TB bronchiectasis were compared to those with bronchiectasis from other aetiologies.
148 participants were included with mean±standard deviation age 63 ± 9 years; 46 (31.1%) had post-TB bronchiectasis and 102 (68.9%) other aetiologies. Compared to other aetiologies, participants with post-TB bronchiectasis had significantly lower body mass index (BMI), more frequent presentation with haemoptysis, lower forced expiratory volume in one second (FEV), more frequent isolation of nontuberculous mycobacteria (NTM), and higher FACED scores indicating greater disease severity. Over a median follow-up of 21 months, post-TB bronchiectasis was associated with shorter time to next hospitalized exacerbation (49 vs 76 months, Log-Rank = .01).
Post-TB bronchiectasis is a distinct entity with higher rates of haemoptysis and NTM isolation, more frequent exacerbations, and greater disease severity.
支气管扩张症是一种具有不同表型的异质性疾病。肺结核后（post-TB）支气管扩张症表型在许多国家都很普遍，但研究不足。我们的目的是确定肺结核后支气管扩张症的不同表型特征。
我们招募了 2010 年 1 月至 2017 年 10 月期间在新加坡樟宜综合医院因支气管扩张症加重而住院的成年人。我们收集了人口统计学、症状、肺功能、微生物学和 FACED 评分。参与者在随访期间直到下一次住院加重或研究结束（以先发生者为准）。由呼吸专科医生诊断为肺结核后支气管扩张症的患者与其他病因引起的支气管扩张症患者进行比较。
共纳入 148 名参与者，平均年龄±标准差为 63 ± 9 岁；46 名（31.1%）为肺结核后支气管扩张症，102 名（68.9%）为其他病因。与其他病因相比，肺结核后支气管扩张症患者的体重指数（BMI）明显较低，更频繁地出现咯血，第一秒用力呼气量（FEV）较低，非结核分枝杆菌（NTM）分离更为频繁，FACED 评分更高，表明疾病严重程度更高。在中位数为 21 个月的随访期间，肺结核后支气管扩张症患者下一次住院加重的时间更短（49 个月 vs 76 个月，对数秩检验=.01）。
肺结核后支气管扩张症是一种独特的实体，具有更高的咯血和 NTM 分离率、更频繁的加重和更高的疾病严重程度。
