Lema Reinhard Elisania, Shayo Grace Ambrose, Nkrumbih Zuhura, Nagu Tumaini Joseph
Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, P. O. Box 65001, Dar es Salaam, Tanzania.
Department of Internal Medicine, Rabininsia Memorial Hospital, P.O. Box 67497, Dar es Salaam Tanzania.
J Clin Tuberc Other Mycobact Dis. 2025 May 30;40:100538. doi: 10.1016/j.jctube.2025.100538. eCollection 2025 Aug.
To document abnormalities in pulmonary function (PF) and associated factors in patients completing treatment for microbiologically confirmed, first-ever pulmonary tuberculosis (PTB).From August 2020 to May 2021, we recruited 332 patients aged ≥15 years. PF was evaluated at baseline and at treatment completion. The Wilcoxon signed-rank test was used to compare median PF changes between baseline and treatment completion. A log-binomial regression model was used to determine factors associated with abnormal PF at treatment completion. Statistical significance was set at ≤ 0.05.
Abnormal PF was observed in 142 of 300 (47.3 %) patients who completed the study. Being male (RR [95 % CI] = 1.22 [1.19-2.23]), underweight (RR = 1.49 [1.13-1.95]), having lung cavitation (RR = 1.90 [1.29-2.78]), and lung fibrosis at baseline (RR = 2.16 [1.32-3.53]) were significantly associated with abnormal PF. The median (IQR) FEV at treatment completion was 2.33 L (0.90-4.23 L) and FVC was 3.05 L (1.10-7.50 L), both significantly higher than FEV of 2.18 L (0.20-5.70 L) and FVC of 2.82 L (0.26-7.05 L) at treatment initiation ( < 0.05 for both).
Approximately half of the patients had abnormal PF at treatment completion. Underweight patients, males, and those with lung cavitation at treatment initiation are more likely to have abnormal PF at the end of treatment and may require special attention.
记录微生物学确诊的初发肺结核(PTB)患者完成治疗后的肺功能(PF)异常情况及相关因素。2020年8月至2021年5月,我们招募了332名年龄≥15岁的患者。在基线和治疗结束时评估PF。采用Wilcoxon符号秩检验比较基线和治疗结束时PF的中位数变化。使用对数二项回归模型确定治疗结束时与PF异常相关的因素。统计学显著性设定为≤0.05。
在完成研究的300名患者中,有142名(47.3%)观察到PF异常。男性(相对危险度[95%置信区间]=1.22[1.19 - 2.23])、体重过轻(相对危险度=1.49[1.13 - 1.95])、有肺空洞(相对危险度=1.90[1.29 - 2.78])以及基线时存在肺纤维化(相对危险度=2.16[1.32 - 3.53])与PF异常显著相关。治疗结束时的中位数(四分位间距)第一秒用力呼气容积(FEV)为2.33升(0.90 - 4.23升),用力肺活量(FVC)为3.05升(1.10 - 7.50升),两者均显著高于治疗开始时的FEV 2.18升(0.20 - 5.70升)和FVC 2.82升(0.26 - 7.05升)(两者均P<0.05)。
约一半的患者在治疗结束时存在PF异常。体重过轻的患者、男性以及治疗开始时有肺空洞的患者在治疗结束时更有可能出现PF异常,可能需要特别关注。