Fu Jiapeng, Li Jian, Liu Zhi, Zheng Shasha, Li Xue, Ning Xianjia, Wang Jinghua, Gao Wenying, Li Guobao
Department of the Third Pulmonary Disease, The Third People's Hospital of Shenzhen, Shenzhen, Guangdong, People's Republic of China.
The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, People's Republic of China.
Int J Gen Med. 2022 Jun 21;15:5741-5750. doi: 10.2147/IJGM.S367070. eCollection 2022.
Tracheobronchial tuberculosis (TBTB) has been proposed to occur more commonly in female patients. However, to date, studies that systematically delineate differences between female and male patients with TB infection are lacking. We aimed to comprehensively assess the sex-specific differences in clinical manifestation, bronchoscopy performance, bacteriological examination, and imaging of TBTB in Shenzhen, China.
All patients with diagnosed TBTB from August 1, 2018 to July 31, 2021 at The Third People's Hospital of Shenzhen were enrolled in the present study. Demographic information, clinical manifestations, blood tests, chest computed tomography, and bronchoscopic findings were collected, and assessed their sex-specific differences.
Of these 331 patients, 238 patients (71.9%) were female, and 93 patients (28.1%) were male, with an overall average age of 37.3 years. The average age of male patients with TBTB was more than 5 years older than that of female patients. The prevalence of lymph fistula and diabetes mellitus was significantly higher in male patients than female patients (8.6% vs 1.7%, = 0.005; 17.2% vs 2.1%, < 0.001). The positive proportion of sputum smear was higher in male patients (27.9%) than in female patients (16.7%, = 0.026). Moreover, the mean monocyte-to-lymphocyte ratio, serum CRP, and IL-6 levels were significantly higher in male patients than in female patients ( < 0.05).
In summary, in patients with TBTB diagnosis, male sex was associated with a high prevalence of diabetes mellitus, lymph fistula, and smear-positive ratio, as well as high inflammation levels. The management of young female and male patients with diabetes mellitus and high inflammation levels should be strengthened. Furthermore, to reduce the burden of TBTB, we must pay attention to the risk of TBTB in past tuberculosis patients, especially male patients under 45 years old and female patients over 45 years old.
气管支气管结核（TBTB）被认为在女性患者中更常见。然而，迄今为止，缺乏系统描述女性和男性结核感染患者之间差异的研究。我们旨在全面评估中国深圳TBTB患者在临床表现、支气管镜检查、细菌学检查和影像学方面的性别差异。
纳入2018年8月1日至2021年7月31日在深圳市第三人民医院确诊的所有TBTB患者。收集人口统计学信息、临床表现、血液检查、胸部计算机断层扫描和支气管镜检查结果，并评估其性别差异。
在这331例患者中，238例（71.9%）为女性，93例（28.1%）为男性，总体平均年龄为37.3岁。男性TBTB患者的平均年龄比女性患者大5岁以上。男性患者中淋巴瘘和糖尿病的患病率显著高于女性患者（8.6%对1.7%，P = 0.005；17.2%对2.1%，P < 0.001）。男性患者痰涂片阳性比例高于女性患者（27.9%对16.7%，P = 0.026）。此外，男性患者的平均单核细胞与淋巴细胞比值、血清CRP和IL-6水平显著高于女性患者（P < 0.05）。
总之，在确诊的TBTB患者中，男性与糖尿病、淋巴瘘和涂片阳性率的高患病率以及高炎症水平相关。应加强对患有糖尿病和高炎症水平的年轻女性和男性患者的管理。此外，为减轻TBTB的负担，我们必须关注既往结核患者中TBTB的风险，尤其是45岁以下的男性患者和45岁以上的女性患者。
