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埃塞俄比亚南部锡达马地区结核病患者治疗结束后的肺功能

Lung function of tuberculosis patients after completion of treatment in Sidama, South Ethiopia.

作者信息

Woldesemayat Endrias Markos, Vera Jaime H, Tanner Clea, Tamiso Alemu, Assefa Amare, Woldesenbet Yohannes Markos

机构信息

College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.

Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom.

出版信息

Front Med (Lausanne). 2025 Mar 18;12:1451861. doi: 10.3389/fmed.2025.1451861. eCollection 2025.

Abstract

INTRODUCTION

Lung function impairment are commonly reported after treatment of pulmonary tuberculosis (TB). This study aimed to examine lung function parameters among adults who have undergone treatment for pulmonary TB.

METHODS

A comparative cross-sectional study was conducted in eight rural communities of Dale district of Sidama Region, Southern Ethiopia. The post-TB group were smear-positive TB patients who successfully completed TB treatment between 2010 and 2021, while controls were selected from the neighbors of these participants with no documented history of TB. Lung function tests were conducted using a portable spirometer, and pulmonary symptoms were assessed using the Saint Georges Respiratory Questionnaire. Obstructive pulmonary impairment was defined as the ratio of FEV1/FVC below 70% and restrictive impairment was defined as having a normal FEV1/FVC ratio with a low FEV. Data were entered and analyzed using SPSS version 25 statistical package.

RESULTS

We enrolled 167 TB cases and 156 controls in the study. The median (IQR) was 38 (21) years for cases and 35 (21.75) years for controls. The median (IQR) time after completion of TB treatment was 24 (31.75) months for the TB cases. A higher proportion of post-TB participants (101/167 (60.5%; 95% confidence interval (CI), 52.9-67.6%)) than controls (63/156 (40.4%; 95% CI, 33.0-48.2%)) had obstructive impairment, = 0.01. Thirty eight (22.8; 95% CI, 17.1-29.7) post-TB participants and 39 (25.0%; 95% CI, 18.9-32.3%) controls had restrictive impairment; = 0.3. Post-TB participants had high risk of obstructive pulmonary impairment (adjusted hazards ratio [aOR], 2.1; 95% CI, 1.3-3.3) and chronic obstructive pulmonary diseases symptoms scores (aOR, 73.0; 95% CI, 35.3-151.2). BMI was associated with obstructive impairment, (aOR, 1.6; 95% CI, 1.0-2.6) and the post-TB participants had increased risk of any impairment (aOR, 2.2; 95% CI, 1.1-4.5).

CONCLUSION

Post-TB participants had greater risk of pulmonary impairment and respiratory symptoms. Post-TB treatment follow-up care is suggested to quickly identify and manage pulmonary impairment.

摘要

引言

肺结核(TB)治疗后肺部功能受损的情况屡见不鲜。本研究旨在检测接受过肺结核治疗的成年人的肺功能参数。

方法

在埃塞俄比亚南部锡达马地区代勒区的8个农村社区开展了一项对比性横断面研究。肺结核治疗后组为2010年至2021年间成功完成肺结核治疗的涂片阳性肺结核患者,而对照组则从这些参与者的邻居中选取,他们没有肺结核病史记录。使用便携式肺活量计进行肺功能测试,并使用圣乔治呼吸问卷评估肺部症状。阻塞性肺损伤定义为第一秒用力呼气容积(FEV1)与用力肺活量(FVC)之比低于70%,限制性损伤定义为FEV1/FVC比值正常但FEV较低。使用SPSS 25版统计软件包录入和分析数据。

结果

本研究纳入了167例肺结核病例和156名对照。病例组的年龄中位数(四分位间距)为38(21)岁,对照组为35(21.75)岁。肺结核病例完成治疗后的时间中位数(四分位间距)为24(31.75)个月。与对照组(63/156(40.4%;95%置信区间(CI),33.0 - 48.2%))相比,肺结核治疗后组中阻塞性损伤的参与者比例更高(101/167(60.5%;95% CI,52.9 - 67.6%)),P = 0.01。38例(22.8%;95% CI,17.1 - 29.7)肺结核治疗后参与者和39例(25.0%;95% CI,18.9 - 32.3%)对照有限制性损伤;P = 0.3。肺结核治疗后参与者发生阻塞性肺损伤的风险较高(调整后风险比[aOR],2.1;95% CI,1.3 - 3.3)以及慢性阻塞性肺疾病症状评分较高(aOR,73.0;95% CI,35.3 - 151.2)。体重指数与阻塞性损伤相关(aOR,1.6;95% CI,1.0 - 2.6),且肺结核治疗后参与者发生任何损伤的风险增加(aOR,2.2;95% CI,1.1 - 4.5)。

结论

肺结核治疗后参与者发生肺部损伤和呼吸道症状的风险更大。建议在肺结核治疗后进行随访护理,以便快速识别和处理肺部损伤。

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