Li Shan, Luo Shui-Rong, Feng Yin-Ping, Xu Bi-Qing
Department of Tuberculosis, Lishui Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Traditional Chinese Medicine, Lishui Tuberculosis Clinical Medical Research Center, Lishui, Zhejiang, China.
Medicine (Baltimore). 2025 Jun 27;104(26):e43089. doi: 10.1097/MD.0000000000043089.
This study explores the factors influencing the persistence of cavities in patients with rifampicin-sensitive pulmonary tuberculosis who have completed outpatient follow-up treatment based on multiple regression analysis. A total of 218 rifampicin-sensitive pulmonary tuberculosis patients with pulmonary cavities, who were followed up at our hospital from January 2022 to October 2023, were selected as the study subjects. General patient data were collected, including gender, age, residence, smoking status, hemoptysis symptoms, presence of diabetes, initial treatment/retreatment, number of outpatient visits, duration of intensive treatment, presence of extrapulmonary tuberculosis, and presence of chronic aspergillosis. Based on a reexamination of chest CT scans to evaluate lung cavity absorption after completion of treatment, patients were categorized into the cavity closure group or cavity persistence group. Multivariate logistic regression analysis was conducted to identify factors influencing cavity persistence, and a forest plot was generated. Among the 218 rifampicin-sensitive pulmonary tuberculosis patients, 55 (25.23%) had persistent pulmonary cavities. Multivariate logistic regression analysis revealed that smoking (OR = 2.209, 95% CI = 1.029-4.739, P = .042), diabetes (OR = 3.423, 95% CI = 1.602-7.315, P = .001), retreatment (OR = 5.286, 95% CI = 1.983-14.087, P < .001), and chronic pulmonary aspergillosis (OR = 5.684, 95% CI = 2.459-13.138, P < .001) were significant factors influencing the persistence of cavities (P < .05). Smoking, diabetes, retreatment of pulmonary tuberculosis, and chronic pulmonary aspergillosis are all factors that influence the persistence of cavities in patients with rifampicin-sensitive pulmonary tuberculosis who have completed treatment in outpatient clinics. Early intervention should be implemented in these cases.
本研究基于多元回归分析，探讨了完成门诊随访治疗的利福平敏感型肺结核患者空洞持续存在的影响因素。选取2022年1月至2023年10月在我院进行随访的218例有空洞的利福平敏感型肺结核患者作为研究对象。收集患者的一般资料，包括性别、年龄、居住地、吸烟状况、咯血症状、是否患有糖尿病、初治/复治、门诊就诊次数、强化治疗时长、是否合并肺外结核以及是否患有慢性曲霉病。根据治疗结束后胸部CT复查评估肺空洞吸收情况，将患者分为空洞闭合组和空洞持续存在组。进行多因素逻辑回归分析以确定影响空洞持续存在的因素，并绘制森林图。在218例利福平敏感型肺结核患者中，55例（25.23%）存在持续性肺空洞。多因素逻辑回归分析显示，吸烟（OR = 2.209，95%CI = 1.029 - 4.739，P = 0.042）、糖尿病（OR = 3.423，95%CI = 1.602 - 7.315，P = 0.001）、复治（OR = 5.286，95%CI = 1.983 - 14.087，P < 0.001）和慢性肺曲霉病（OR = 5.684，95%CI = 2.459 - 13.138，P < 0.001）是影响空洞持续存在的显著因素（P < 0.05）。吸烟、糖尿病、肺结核复治以及慢性肺曲霉病均是影响完成门诊治疗的利福平敏感型肺结核患者空洞持续存在的因素。对此类情况应实施早期干预。
