Joo Dong-Hyun, Kim Min Chul, Sin Sooim, Kang Hye-Rin, Song Jin Hwa, Kim Hyung-Jun, Song Myung Jin, Kwon Byoung Soo, Kim Yeon Wook, Lee Yeon Joo, Park Jong Sun, Lee Jae Ho, Lee Ye Jin
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Centre, Seoul, Republic of Korea.
Int J Chron Obstruct Pulmon Dis. 2025 Jun 26;20:2091-2102. doi: 10.2147/COPD.S523732. eCollection 2025.
Chronic obstructive pulmonary disease (COPD) is influenced by multiple factors. Varying prevalences of tuberculosis-associated COPD exist. However, studies on its incidence or risk factors are limited. We evaluated the incidence of tuberculosis-associated COPD and compare the characteristics of patients with and without COPD.
This multicenter, retrospective cohort study included 351 patients treated with anti-tuberculosis drugs for more than 6 months in four hospitals in Korea, followed for 11 years (132 months). The follow-up duration was divided into quartiles (Q1-Q4) to evaluate the change in the incidence of COPD over time. Clinical data and radiological findings were collected, and the incidence rate ratios were compared using Poisson regression and multivariable logistic regression analysis to identify risk factors.
Overall, 71 participants developed tuberculosis-associated COPD, with an overall crude incidence of 20.56/1000 person-years. Patients with tuberculosis-associated COPD were older, more likely to be smokers, and had lower forced expiratory volume in 1 s (FEV1) (L) and lower FEV1/forced vital capacity. The incidence over 132 months was significantly lower than those during follow-up, with an incidence rate ratio of 0.49 (p=0.027). Multivariate analysis revealed that a tuberculosis diagnosis at an older age (adjusted odds ratio [aOR] 1.04; 95% confidence interval [CI]: 1.01-1.07), lower baseline FEV1 <80% (aOR 3.98; 95% CI: 1.92-8.24), smoking (aOR 3.23; 95% CI: 1.14-9.17), and multilobar involvement of tuberculosis (aOR 2.04; 95% CI: 1.08-3.85) were risk factors for tuberculosis-associated COPD. The incidence in the Q4 (>132 months, approximately 11years) was significantly lower than that in the Q1 (18-71 months), with incidence rate ratio of 0.49 (p= 0.027).
Older age at tuberculosis diagnosis, lower baseline FEV1 <80%, smoking history, and multilobar involvement were identified as risk factors for tuberculosis-associated COPD. The incidence of tuberculosis-associated COPD decreased 11 years after tuberculosis treatment.
慢性阻塞性肺疾病（COPD）受多种因素影响。与结核病相关的COPD患病率各不相同。然而，关于其发病率或危险因素的研究有限。我们评估了与结核病相关的COPD的发病率，并比较了有和没有COPD的患者的特征。
这项多中心回顾性队列研究纳入了韩国四家医院中接受抗结核药物治疗超过6个月的351例患者，随访11年（132个月）。将随访时间分为四分位数（Q1-Q4）以评估COPD发病率随时间的变化。收集临床数据和影像学检查结果，并使用泊松回归和多变量逻辑回归分析比较发病率比，以确定危险因素。
总体而言，71名参与者患上了与结核病相关的COPD，总体粗发病率为20.56/1000人年。与结核病相关的COPD患者年龄较大，更可能是吸烟者，且第1秒用力呼气量（FEV1）（升）较低，FEV1/用力肺活量也较低。132个月期间的发病率明显低于随访期间，发病率比为0.49（p=0.027）。多变量分析显示，年龄较大时诊断为结核病（调整优势比[aOR]1.04；95%置信区间[CI]：1.01-
