Particulate matter is associated with sputum culture conversion in patients with culture-positive tuberculosis.
Particulate matter is associated with sputum culture conversion in patients with culture-positive tuberculosis.
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DOI：
10.2147/tcrm.s92927
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发表时间：
2016
影响因子：
2.8
通讯作者：
Chuang HC
中科院分区：
文献类型：
--
作者：
Chen KY;Chuang KJ;Liu HC;Lee KY;Feng PH;Su CL;Lin CL;Lee CN;Chuang HC
新出现的结核病（TB）感染风险因素，如空气污染，在个人和人群层面都发挥着重要作用。然而，空气污染与结核病之间的关系仍不清楚。本研究的目的是探讨室外空气污染与肺结核患者痰培养转化之间的关系。在本研究中，从2010年至2012年从台湾的一家医院招募了389名受试者：144名痰培养阴性的非TB相关肺部疾病对照组和245名培养阳性的TB受试者。我们观察到，空气动力学直径≤10 μm的颗粒物（PM10）增加1 μg/m3，导致结核病的几率增加4%（比值比=1.04，95%置信区间=1.01-1.08，P<0.05）。肺结核患者的X线胸片分级与1年PM10水平相关（R2=0.94，P<0.05）。然而，肺空洞或治疗成功率与PM10无关。在结核菌培养阳性的受试者中，每年暴露于≥50 μg/m3的PM10与痰培养转换所需时间的增加相关（风险比=1.28，95%置信区间：1.07-1.84，P<0.05）。总之，长期暴露于≥50 μg/m3的PM10可能延长结核菌阳性结核病患者的痰培养转化。
Emerging risk factors for tuberculosis (TB) infection, such as air pollution, play a significant role at both the individual and population levels. However, the association between air pollution and TB remains unclear. The objective of this study was to examine the association between outdoor air pollution and sputum culture conversion in TB patients. In the present study, 389 subjects were recruited from a hospital in Taiwan from 2010 to 2012: 144 controls with non-TB-related pulmonary diseases with negative sputum cultures and 245 culture-positive TB subjects. We observed that a 1 μg/m3 increase in particulate matter of ≤10 μm in aerodynamic diameter (PM10) resulted in 4% higher odds of TB (odds ratio =1.04, 95% confidence interval =1.01–1.08, P<0.05). The chest X-ray grading of TB subjects was correlated to 1 year levels of PM10 (R2=0.94, P<0.05). However, there were no associations of pulmonary cavitation or treatment success rate with PM10. In subjects with TB-positive cultures, annual exposure to ≥50 μg/m3 PM10 was associated with an increase in the time required for sputum culture conversion (hazard ratio =1.28, 95% confidence interval: 1.07–1.84, P<0.05). In conclusion, chronic exposure to ≥50 μg/m3 PM10 may prolong the sputum culture conversion of TB patients with sputum-positive cultures.