Sex Disparity in Severity of Lung Lesions in Newly Identified Tuberculosis Is Age-Associated
Sex Disparity in Severity of Lung Lesions in Newly Identified Tuberculosis Is Age-Associated
复制标题
新发现结核病肺部病变严重程度的性别差异与年龄相关
DOI：
10.3389/fmed.2019.00163
复制
发表时间：
2019-07-17
影响因子：
3.9
通讯作者：
Feng, Yonghong
中科院分区：
文献类型：
--
作者：
Chu, Yue;Soodeen-Lalloo, Adiilah K.;Feng, Yonghong
背景资料：肺结核CT影像的年龄特征及男性偏误的原因尚不清楚。研究方法：我们比较了594例年龄从15岁到92岁的非吸烟男性和女性新诊断的结核病的CT图像、临床炎症指标和痰细菌计数。Logistic回归分析用于确定男性和女性的腔相关因素，单独和组合。结果如下：15 ~ 74岁的男性痰菌数、空洞率、肺损伤评分和C反应蛋白水平均显著高于女性，但75岁以上的男性则无显著差异。在CT图像中，厚壁空洞、瘢痕性肺气肿和实质条索在15-74岁男性中比匹配的女性多出现。男性在56岁以后患小叶性肺气肿和胸腔积液的比例更高。而肺实质条索、钙化、胸腔积液、胸膜增厚、小叶气肿和支气管血管扭曲的病例比例随年龄增长而增加，小叶中心结节、微小结节和树芽的病例比例随年龄增长而减少。红细胞沉降率（ESR）随着年龄的增长而增加，但在ESR或T-SPOT TB测试中没有发现男性和女性之间的差异。男性补体C4增高、体重指数降低及女性抗结核抗体阳性与空洞的存在密切相关。结论：结核病的性别偏见与年龄相关。结核病的预防、治疗和研究应考虑到性别和年龄的差异。
Background: The age-associated characteristic of computed tomography (CT) images of tuberculosis (TB) and the reason for male bias in TB are still not clear. Methods: We compared the CT images, clinical inflammatory indices and sputum bacterial counts between 594 non-smoking men and women with newly diagnosed TB with matched large span of ages from 15 to 92 years old. Logistic regression analyses were used to identify the cavity-associated factors of men and women, separately and in combination. Results: Sputum bacterial counts, ratio of cavities, lung injury scores, and level of C reactive protein were significantly higher in men than in women with ages from 15 to 74, but not in cases older than 75. In CT images, thick walled cavity, cicatricial emphysema and parenchymal bands were present in men at ages of 15–74 more than matched women. Ratios of cases with lobular emphysema and pleural effusion were higher in men after age of 56. While ratios of cases with parenchymal bands, calcification, pleural effusion, pleural thickening, lobular emphysema and bronchovascular distortion increased with aging, those of centrilobular nodules, micronodules and tree in bud decreased with aging in men. Erythrocyte sedimentation rate (ESR) increased with aging, but no differences were found between men and women in ESR or T-SPOT TB tests. Higher complement C4 and lower body mass index in men and positive result in anti-TB antibody test in women were strongly associated with the presence of cavity. Conclusions: The sex bias in TB is age-associated. TB prevention, treatment and research should take differences of sex and age into account.