Shanghai Jiaotong Daxue xuebao. Yixue ban (Aug 2023)

Analysis of the effect of anti-tuberculosis treatment and lung injury in patients with tuberculosis combined with underlying disease

  • LUO Mengxing,
  • ZOU Xin,
  • GAO Yaxian,
  • WU Xiaocui,
  • YU Fangyou,
  • HU Yang,
  • ZENG Qibing,
  • LIU Zhonghua

DOI
https://doi.org/10.3969/j.issn.1674-8115.2023.08.009
Journal volume & issue
Vol. 43, no. 8
pp. 1017 – 1023

Abstract

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Objective·To investigate the impact of complications on the prognosis and lung injury of patients with tuberculosis..Methods·A retrospective cohort study was used for analysis, to select a total of 450 smear-positive tuberculosis (TB) patients, 323 males (71.8%) and 127 females (28.2%), from January to December 2018 at Shanghai Pulmonary Hospital, Tongji University School of Medicine, which were divided into non-complication group and complication group (diabetes, hypertension, liver diseases, kidney diseases and gallbladder diseases). Overall treatment outcomes and lung injuries in TB patients with and without complications were analyzed by using χ2 test. Stratified analysis of the impact of each comorbidity on the prognosis and lung injury of TB patients was performed. Kaplan-Meier analysis was used to analyze the temporal correlation between complications and tuberculosis prognosis.Results·Four hundred and fifty patients with a median age of 33 years were included, 173 of whom had complications: diabetes in 49 cases, hypertension in 23 cases, liver diseases in 83 cases, kidney diseases in 35 cases, and gallbladder diseases in 17 cases. The cure rate of TB patients without complications was 80.5%, which was significantly higher than that of the group with complications (P<0.05); the significantly lower cure rate of TB patients with diabetes, hypertension and kidney diseases at diagnosis was the key cause of anti-tuberculosis treatment failure; TB patients with diabetes and liver diseases had higher lung bacterial load and larger areas of lung damage, and TB patients with diabetes and kidney diseases had higher incidence of pulmonary cavity.Conclusion·Diabetes, hypertension and kidney diseases exacerbate lung damage and lead to lower TB cure rates. Early interventions by clinicians at the time of diagnosis can improve cure rates, shorten treatment time, and reduce medical costs for TB patients.

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