Zhongguo quanke yixue (May 2022)
Pulmonary Function and Imaging Characteristics of Tuberculosis Associated Obstructive Pulmonary Disease Using Propensity Score-matched Analysis
Abstract
Background Studies on tuberculosis associated obstructive pulmonary disease (TOPD) are still scarce in China, a country with a high burden of tuberculosis and chronic obstructive pulmonary disease (COPD) . Objective To compare clinical features and pulmonary functions between TOPD and COPD, and to explore the relationship between imaging features and pulmonary function in TOPD, aiming at providing information for improving clinicians' understanding of TOPD. Methods A retrospective design was adopted. TOPD (n=387) and COPD (n=364) patients were recruited from the Fourth Clinical Medical College of Xinjiang Medical University from January 2018 to November 2020. The TOPD patients were matched with COPD patients at a ratio of 1∶2 using propensity score matching based on age, gender, ethnic group and other baseline data. Clinical data and lung function indices (FEV1/FVC, FEV1%pre, and FVC%pre) were compared between the groups before and after matching. Imaging manifestations of TOPD patients were further described. Spearman rank correlation analysis was used to analyze the correlation of imaging features with lung function. Results The two matched groups had no significant differences in sex ratio, mean age, and ethnic group distribution (P>0.05) . Compared to COPD patients, TOPD patients had mean younger age of onset, longer mean length of hospital stay, and lower mean levels of FEV1/FVC, and FEV1%pre (P<0.05) . Imaging examination showed that the sites of tuberculosis scar in TOPD patients were mostly in upper and lower lobes of the right lung, and some patients had signs of emphysema and bronchiectasis to a certain extent. Spearman correlation analysis showed that the number of lung lobes affected by tuberculosis was negatively correlated with FEV1/FVC, FEV1%pre, and FVC%pre (rs=-0.202, P=0.011; rs=-0.456, P<0.001; rs=-0.442, P<0.001) . Conclusion Compared with COPD patients, TOPD patients were characterized by younger age, longer hospital stay, and severer obstructive ventilatory disorder. In addition, lung function decreased with the increase in the number of lobes affected by tuberculosis.
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