Bajpai Jyoti, Kant Surya, Verma Ajay, Bajaj Darshan K
Respiratory Medicine, King George's Medical University, Lucknow, IND.
Respiratory Medicine and Pulmonary Critical Care, King George's Medical University, Lucknow, IND.
Cureus. 2023 Feb 7;15(2):e34747. doi: 10.7759/cureus.34747. eCollection 2023 Feb.
Introduction Among chronic respiratory diseases, bronchiectasis is one of the important causes of mortality and morbidity in developing countries. Objective This study aimed to assess the clinical, radiological, microbiological, and pulmonary function profiles of adult patients with post-tubercular bronchiectasis. Methods We enrolled 138 patients with bronchiectasis confirmed by high-resolution CT scans from July 2017 to August 2018. Results A total of 138 patients with bronchiectasis were enrolled. The data from 132 patients were analyzed; six patients were excluded from the study. The mean age of post-TB bronchiectasis (post-tuberculosis bronchiectasis) patients was 36.08±13.08, which was lower than the non-tuberculosis bronchiectasis group. The proportion of the male population was more in the post-TB bronchiectasis group (54.55% vs. 37.88%, p=0.48). Smoking prevalence was high in post-TB bronchiectasis (27.27% vs. 12.12%, p=0.04). The predominant symptom was cough in the post-tubercular bronchiectasis group (48.5% vs. 41.7%, p=0.019). The history of the recurrent common cold was seen most frequently in non-post-tubercular bronchiectasis (40.9% vs. 12.9%, p=0.001). The most common radiological variant of bronchiectasis found in all patients was a cystic type (75%). The most common site of involvement was the left lower lobe, followed by the lingula in all patients and post-tuberculosis bronchiectasis patients. Pulmonary function on spirometry revealed obstructive, restrictive, and mixed patterns in 55%, 25%, and 15%, respectively. Patients with post-tuberculosis bronchiectasis had lower lung function post-FEV1/FVC (forced expiratory volume in one second/forced vital capacity) ratio (70.31±15.56 vs. 76.85±11.82, p=0.015). Binary multivariate logistic regression analysis showed that only recurrent cough cold was a significant independent risk factor for post-TB bronchiectasis. Conclusion Post-tuberculosis, and bronchiectasis followed by post-infectious causes, were the most common causes of bronchiectasis and poor lung function.
引言 在慢性呼吸道疾病中,支气管扩张是发展中国家死亡率和发病率的重要原因之一。目的 本研究旨在评估成人肺结核后支气管扩张患者的临床、放射学、微生物学和肺功能特征。方法 我们纳入了2017年7月至2018年8月期间经高分辨率CT扫描确诊的138例支气管扩张患者。结果 共纳入138例支气管扩张患者。分析了132例患者的数据;6例患者被排除在研究之外。肺结核后支气管扩张患者的平均年龄为36.08±13.08岁,低于非结核性支气管扩张组。肺结核后支气管扩张组男性人口比例更高(54.55%对37.88%,p = 0.48)。肺结核后支气管扩张患者吸烟率较高(27.27%对12.12%,p = 0.04)。肺结核后支气管扩张组的主要症状是咳嗽(48.5%对41.7%,p = 0.019)。反复感冒史在非肺结核后支气管扩张患者中最为常见(40.9%对12.9%,p = 0.001)。所有患者中发现的支气管扩张最常见的放射学类型是囊性(75%)。最常见的受累部位是左肺下叶,其次是所有患者和肺结核后支气管扩张患者的舌叶。肺功能肺活量测定显示阻塞性、限制性和混合性模式分别为55%、25%和15%。肺结核后支气管扩张患者FEV1/FVC(一秒用力呼气量/用力肺活量)比值后的肺功能较低(70.31±15.56对76.85±11.82,p = 0.015)。二元多因素逻辑回归分析显示,只有反复咳嗽感冒是肺结核后支气管扩张的显著独立危险因素。结论 肺结核后以及感染后原因导致的支气管扩张是支气管扩张和肺功能差的最常见原因。