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儿童肺结核后的肺功能、生活质量及影像学表现

Post-TB lung function, quality of life, and radiographic findings in children.

作者信息

Becker G L, Kisembo H, Sato Y, Wendt L H, Aanyu-Tukamuhebwa H, Nantanda R, Jackson J B, Blount R J, Wobudeya E

机构信息

Department of Internal Medicine, University of Iowa, Iowa City, Iowa, USA.

Department of Radiology, Mulago National Referral Hospital, Kampala, Uganda.

出版信息

IJTLD Open. 2025 Jul 9;2(7):427-433. doi: 10.5588/ijtldopen.24.0675. eCollection 2025 Jul.

Abstract

BACKGROUND

The long-term effects of pulmonary TB (PTB) on pediatric lung health are poorly understood. Our objective was to assess predictors of lung function and describe health-related quality of life (QoL) and chest radiograph findings in children following PTB treatment in Kampala, Uganda.

METHODS

We performed a cross-sectional study of children aged 6-16 years who completed PTB treatment within the last five years compared to household controls with no history of active TB. Children underwent chest radiograph, St. George's Respiratory Questionnaire, and spirometry. Mixed-effects regression models were performed to assess predictors of lung function impairment.

RESULTS

We enrolled 73 children with prior TB and 49 controls. In univariate mixed-effects regression models, prior TB was associated with lower FEV1 and FVC Z-scores (p<0.05). In multivariate models, BMI-for-age Z-score predicted FVC-Z-score (p<0.001). Fibrosis and pleural thickening were common radiographic abnormalities among children with prior TB. Median SGRQ total score was higher among children with prior TB (p<0.001).

CONCLUSION

Children with prior TB showed reduced lung function and QoL compared to household controls. Our findings support the need for routine clinical follow-up after TB treatment.

摘要

背景

肺结核(PTB)对儿童肺部健康的长期影响尚不清楚。我们的目的是评估肺功能的预测因素,并描述乌干达坎帕拉接受PTB治疗的儿童的健康相关生活质量(QoL)和胸部X光片检查结果。

方法

我们对过去五年内完成PTB治疗的6至16岁儿童进行了一项横断面研究,并与无活动性结核病病史的家庭对照进行比较。儿童接受了胸部X光片检查、圣乔治呼吸问卷和肺活量测定。采用混合效应回归模型评估肺功能损害的预测因素。

结果

我们纳入了73名曾患结核病的儿童和49名对照。在单变量混合效应回归模型中,既往结核病与较低的第一秒用力呼气容积(FEV1)和用力肺活量(FVC)Z评分相关(p<0.05)。在多变量模型中,年龄别体重指数Z评分可预测FVC-Z评分(p<0.001)。纤维化和胸膜增厚是既往患结核病儿童常见的影像学异常。既往患结核病儿童的圣乔治呼吸问卷总分中位数较高(p<0.001)。

结论

与家庭对照相比,既往患结核病的儿童肺功能和生活质量较低。我们的研究结果支持结核病治疗后需要进行常规临床随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8b3/12248413/c07891fc9dce/ijtldopen24-0675f1.jpg

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