Impact of emphysema on sputum culture conversion in male patients with pulmonary tuberculosis: a retrospective analysis.
Impact of emphysema on sputum culture conversion in male patients with pulmonary tuberculosis: a retrospective analysis.
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DOI：
10.1186/s12890-020-01325-1
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发表时间：
2020-11-07
影响因子：
3.1
通讯作者：
Kuwano K
中科院分区：
文献类型：
--
作者：
Takasaka N;Seki Y;Fujisaki I;Uchiyama S;Matsubayashi S;Sato A;Yamanaka Y;Odashima K;Kazuyori T;Seki A;Takeda H;Ishikawa T;Kuwano K
尽管吸烟可能对肺结核（PTB）的临床结果有负面影响，但很少有研究调查吸烟相关肺部疾病的影响。肺气肿是吸烟相关肺损伤的主要病理表现。我们旨在阐明肺气肿对结核分枝杆菌（MTB）痰培养转化率的影响。我们回顾性研究了2015年1月至2018年12月间在纪庆大学岱山医院通过抗酸杆菌涂片和培养确诊的79例男性肺结核患者。我们调查了有或没有肺气肿的患者在开始标准抗结核治疗后结核分枝杆菌的痰培养转化率。肺气肿定义为基于计算机断层扫描（CT）低衰减区域< - 950 Hounsfield Unit （HU）的Goddard评分≥1。我们还评估了抗结核治疗前对ptb相关CT表现的影响。38例合并肺气肿的结核分枝杆菌培养转化中位时间（TCC）为52.0天[四分位间距（IQR） 29.0 ~ 66.0天]，与41例无肺气肿患者（28.0天，IQR 14.0 ~ 42.0天）相比，结核分枝杆菌培养转化中位时间（TCC）明显延迟（p < 0.001， log-rank检验）。多因素Cox比例风险分析显示，以下因素与迟发性TCC相关：肺气肿[风险比（HR）： 2.43；95%置信区间（CI）： 1.18-4.97；p = 0.015)、蛀牙（HR: 2.15; 95% CI: 1.83-3.89; p = 0.012）和2周内检测到结核病的基线时间（HR: 2.95; 95% CI: 1.64-5.31; p < 0.0001）。合并肺气肿的肺结核患者CT更容易发现空腔和实变（71.05% vs 43.90%, p = 0.015; 84.21% vs 60.98%, p = 0.021）。本研究提示肺气肿增加了PTB患者迟发性TCC的风险。CT检测肺气肿可能是预测痰阴性转化所需治疗时间的有效方法。
Although cigarette smoking may have a negative impact on the clinical outcome of pulmonary tuberculosis (PTB), few studies have investigated the impact of smoking-associated lung diseases. Emphysema is a major pathological finding of smoking-related lung damage. We aimed to clarify the effect of emphysema on sputum culture conversion rate for Mycobacterium tuberculosis (MTB). We retrospectively studied 79 male patients with PTB confirmed by acid-fast bacillus smear and culture at Jikei University Daisan Hospital between January 2015 and December 2018. We investigated the sputum culture conversion rates for MTB after starting standard anti-TB treatment in patients with or without emphysema. Emphysema was defined as Goddard score ≥ 1 based on low attenuation area < − 950 Hounsfield Unit (HU) using computed tomography (CT). We also evaluated the effect on PTB-related CT findings prior to anti-TB treatment. Mycobacterial median time to culture conversion (TCC) in 38 PTB patients with emphysema was 52.0 days [interquartile range (IQR) 29.0–66.0 days], which was significantly delayed compared with that in 41 patients without emphysema (28.0 days, IQR 14.0–42.0 days) (p < 0.001, log-rank test). Multivariate Cox proportional hazards analysis showed that the following were associated with delayed TCC: emphysema [hazard ratio (HR): 2.43; 95% confidence interval (CI): 1.18–4.97; p = 0.015), cavities (HR: 2.15; 95% CI: 1.83–3.89; p = 0.012) and baseline time to TB detection within 2 weeks (HR: 2.95; 95% CI: 1.64–5.31; p < 0.0001). Cavities and consolidation were more often identified by CT in PTB patients with than without emphysema (71.05% vs 43.90%; p = 0.015, and 84.21% vs 60.98%; p = 0.021, respectively). This study suggests that emphysema poses an increased risk of delayed TCC in PTB. Emphysema detection by CT might be a useful method for prediction of the duration of PTB treatment required for sputum negative conversion.
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影响因子：
3.7
作者：
Atwine, Daniel;Orikiriza, Patrick;Bonnet, Maryline
通讯作者：
Bonnet, Maryline
影响因子：
3.7
作者：
Kanda, Rie;Nagao, Taishi;Nakano, Yasutaka
通讯作者：
Nakano, Yasutaka
DOI：
10.1152/ajplung.00020.2002
发表时间：
2002-10-01
影响因子：
4.9
作者：
Russell, REK;Thorley, A;Barnes, PJ
通讯作者：
Barnes, PJ
影响因子：
168.9
作者：
Brusselle, Guy G.;Joos, Guy F.;Bracke, Ken R.
通讯作者：
Bracke, Ken R.
影响因子：
3.7
作者：
Inghammar, Malin;Ekbom, Anders;Egesten, Arne
通讯作者：
Egesten, Arne