Journal of Shanghai Jiao Tong University (Medical Science) >

2023 , Vol. 43 >Issue 8: 1017 - 1023

DOI: https://doi.org/10.3969/j.issn.1674-8115.2023.08.009

Clinical research

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

  • Mengxing LUO ,
  • Xin ZOU ,
  • Yaxian GAO ,
  • Xiaocui WU ,
  • Fangyou YU ,
  • Yang HU ,
  • Qibing ZENG ,
  • Zhonghua LIU
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  • 1.Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang 550025, China
    2.Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China
LIU Zhonghua, E-mail: nllzh@126.com. Co-corresponding authors.
ZENG Qibing, E-mail: zengqibing@gmc.edu.cn. Co-corresponding authors.

Received date: 2023-04-25

  Accepted date: 2023-05-29

  Online published: 2023-08-28

Supported by

National Natural Science Foundation of China(81970009);The Open Foundation for Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education(GMU-2022-HJZ-04)

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Abstract

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.

Key words： tuberculosis; complication; prognosis; lung damage

Cite this article

Mengxing LUO , Xin ZOU , Yaxian GAO , Xiaocui WU , Fangyou YU , Yang HU , Qibing ZENG , Zhonghua LIU . Analysis of the effect of anti-tuberculosis treatment and lung injury in patients with tuberculosis combined with underlying disease[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023 , 43(8) : 1017 -1023 . DOI: 10.3969/j.issn.1674-8115.2023.08.009

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