Wang Wei, Wang Xiaomeng, Chen Songhua, Li Jun, Cheng Qinglin, Zhang Yu, Wu Qian, Liu Kui, Jiang Xuli, Chen Bin
Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.
Zhejiang Key Lab of Vaccine, Infectious Disease Prevention and Control, Hangzhou, Zhejiang, China.
Front Med (Lausanne). 2025 Jan 28;12:1446835. doi: 10.3389/fmed.2025.1446835. eCollection 2025.
To identify the composition of comorbidities among patients with newly diagnosed pulmonary tuberculosis and assess the impact of comorbidities on the clinical characteristics of patients.
This study was conducted in 13 hospitals across 13 counties in Zhejiang province, China. Patient data collected in this study included demographic characteristics, chest radiography results, etiological results, and comorbidities. Descriptive statistics were conducted to describe the composition of comorbidities of all participants. Univariate and multivariate logistic regression analyzes were performed to identify the effects of comorbidities on the clinical features of the participants.
Of the 8,421 total participants, 27.6% reported cavities in the chest radiography results, 41.9% were -positive in the etiology test results, and 38.7% (3,258/8,421) had at least one type of comorbidity. The most predominant comorbidity was pleuritis (1,833, 21.8%), followed by diabetes mellitus (763, 9.1%), other extrapulmonary tuberculosis (421, 5%), tracheobronchial tuberculosis (275, 3.3%), and silicosis (160, 1.9%). Participants with diabetes mellitus had the highest rate of chest cavities on X-ray (54.8%), followed by those with silicosis (33.1%). In addition, a higher percentage of the -positive etiology (45%) was observed in participants without comorbidities than in participants with comorbidities (37.1%). Compared to patients without comorbidities, patients with diabetes mellitus (adjusted odds ratio [AOR]: 2.88, 95% confidence interval [CI]: 2.42-3.43) were more likely to show cavities in chest X-ray, while patients with pleuritis (AOR: 0.27, 95% CI: 0.23-0.32), other extrapulmonary tuberculosis (AOR: 0.48, 95% CI: 0.36-0.64), and tracheobronchial tuberculosis (AOR: 0.40-0.79) were less likely to show chest cavities in X-ray. In addition, patients with diabetes mellitus (AOR: 2.05, 95% CI: 1.72-2.45), tracheobronchial tuberculosis (AOR: 3.22, 95% CI: 2.4-4.32) were more likely to show -positive in the etiology, and patients with pleuritis (AOR: 0.25, 95% CI: 0.22-0.29), other extrapulmonary tuberculosis (AOR: 0.61, 95% CI: 0.48-0.76) were less likely to show -positive in the etiology.
The prevalence of comorbidities was high in patients newly diagnosed with pulmonary tuberculosis. Thus, integration of screening and personalized management is needed for the control of tuberculosis and its comorbidities.
确定新诊断肺结核患者的合并症构成，并评估合并症对患者临床特征的影响。
本研究在中国浙江省13个县的13家医院开展。本研究收集的患者数据包括人口统计学特征、胸部X线检查结果、病因学检查结果及合并症。进行描述性统计以描述所有参与者的合并症构成。进行单因素和多因素逻辑回归分析以确定合并症对参与者临床特征的影响。
在8421名参与者中，27.6%的胸部X线检查结果显示有空洞，41.9%的病因学检查结果为阳性，38.7%（3258/8421）至少有一种合并症。最主要的合并症是胸膜炎（1833例，21.8%），其次是糖尿病（763例，9.1%）、其他肺外结核（421例，5%）、气管支气管结核（275例，3.3%）和矽肺（160例，1.9%）。糖尿病患者胸部X线有空洞的比例最高（54.8%），其次是矽肺患者（33.1%）。此外，无合并症参与者的病因学阳性比例（45%）高于有合并症参与者（37.1%）。与无合并症患者相比，糖尿病患者（调整优势比[AOR]：2.88，95%置信区间[CI]：2.42 - 3.43）胸部X线更易出现空洞，而胸膜炎患者（AOR：0.27，95%CI：0.23 - 0.32）、其他肺外结核患者（AOR：0.48，95%CI：0.36 - 0.64）和气管支气管结核患者（AOR：0.40 - 0.79）胸部X线出现空洞的可能性较小。此外，糖尿病患者（AOR：2.05，95%CI：1.72 - 2.45）、气管支气管结核患者（AOR：3.22，95%CI：2.4 - 4.32）病因学更易呈阳性，而胸膜炎患者（AOR：0.25，95%CI：0.22 - 0.29）、其他肺外结核患者（AOR：0.61，95%CI：0.48 - 0.76）病因学呈阳性的可能性较小。
新诊断肺结核患者中合并症的患病率较高。因此，控制结核病及其合并症需要整合筛查和个性化管理。
