Persistent chronic respiratory symptoms despite TB cure is poorly correlated with lung function.
Persistent chronic respiratory symptoms despite TB cure is poorly correlated with lung function.
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DOI：
10.5588/ijtld.20.0906
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发表时间：
2021-04-01
期刊：
影响因子：
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通讯作者：
Mortimer K
中科院分区：
文献类型：
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作者：
Allwood BW;Stolbrink M;Baines N;Louw E;Wademan DT;Lupton-Smith A;Nel S;Maree D;Mpagama S;Osman M;Marx FM;Hoddinott G;Lesosky M;Rylance J;Mortimer K
持续的呼吸道症状和肺功能缺陷在结核病患者后很常见。我们的目标是定义结核病后肺部疾病(PTLD)的负担，并在两个结核病高发社区评估症状和损害之间的关系。这是一项对南非开普敦1-5年前完成结核病治疗的成年人的横断面调查。通过问卷调查、肺活量测定和6分钟步行距离(6MWD)来评估结局指标与相关因素之间的关系。在145名受试者中(平均年龄42岁，范围18-75岁；55名女性[38%])，55名(38%)有气流阻塞，84名(58%)用力肺活量(FVC)低，平均6MWD为463m(范围240-723)。呼吸道症状常见：慢性咳嗽27例(19%)，喘息61例(42%)，呼吸困难(改良MRC呼吸困难评分3~4分36例，25%)。FVC、梗阻与6MWD相关性较差。只有低体重指数与多变量分析的结果一致。只有19名参与者(13%)被诊断为呼吸系统疾病，16名(11%)目前接受了吸入器。在这个“治愈”的人群中，有大量的症状负担和生理损害，但客观结果指标之间的相关性很差，这突显了我们对PTLD的理解存在缺陷。
Persistent respiratory symptoms and lung function deficits are common after patients with TB. We aimed to define the burden of post-TB lung disease (PTLD) and assess associations between symptoms and impairment in two high TB incidence communities. This was a cross-sectional survey of adults in Cape Town, South Africa who completed TB treatment 1–5 years previously. Questionnaires, spirometry and 6-minute walking distance (6MWD) were used to assess relationships between outcome measures and associated factors. Of the 145 participants recruited (mean age: 42 years, range: 18–75; 55 [38%] women), 55 (38%) had airflow obstruction and 84 (58%) had low forced vital capacity (FVC); the mean 6MWD was 463 m (range: 240–723). Respiratory symptoms were common: chronic cough (n = 27, 19%), wheeze (n = 61, 42%) and dyspnoea (modified MRC dyspnoea score 3 or 4: n = 36, 25%). There was poor correlation between FVC or obstruction and 6MWD. Only low body mass index showed consistent association with outcomes on multivariable analyses. Only 19 (13%) participants had a diagnosis of respiratory disease, and 16 (11%) currently received inhalers. There was substantial burden of symptoms and physiological impairment in this “cured” population, but poor correlation between objective outcome measures, highlighting deficits in our understanding of PTLD.