Synchronization of Sputum Conversion and Resolution of Intensive Phase Lesion Areas on Thorax X-rays Determinants of Prognosis for Pulmonary Tuberculosis Therapy

Medical and Health Science Journal Pub Date : 2023-11-24 DOI:10.33086/mhsj.v7i02.4565

Utami Ambarsari, Muzaijadah Retno Arimbi, Lysa Veterini, Yunita Lestari Indrianto, N. Candini, H. Notobroto

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Abstract

Background: Pulmonary tuberculosis (TB) is a chronic infectious disease caused by the bacterium Mycobacterium tuberculosis. Diagnosis of TB can be confirmed in two ways, namely bacteriological diagnosis (if AFB sputum is found (+) and clinical diagnosis is (if BTA sputum is found (-), but chest X-ray is (+) TB). Objective: to determine the alignment of sputum conversion and extensive resolution of intensive phase lesions on chest radiographs which determine the prognosis of pulmonary TB therapy. Methods: The study design was a retrospective cohort analytic with a retrospective longitudinal study design. Data from medical records of pulmonary TB patients who have undergone therapy for six months or more at the Pulmonary Polyclinic RSI Jemursari Surabaya. The number of samples was 48 patients aged 41-60 years. All of these pulmonary TB patients were smear positive (BTA+). X-ray examination was done before and after therapy. Results: analysis using the Wilcoxon Signed Rank test to assess differences in the grade of lung lesions before and after therapy, obtained p = 0.003 (p <0.05) meaning there is a significant difference. Sputum conversion was also carried out after therapy, 89.6% of TB patients in this study experienced sputum conversion (BTA negative). To determine the alignment of sputum conversion with the resolution of lesion area, Kappa coefficient analysis K=0.033 (p>0.05) was performed with the results of 50% of patients, 47.9% showed improvement in lung lesions and sputum conversion, while 2.1% showed no improvement of lung lesions and no sputum conversion. The rest, 50% showed no congruence in the results of lung lesion repair and sputum conversion. Conclusion: The results of Kappa coefficient analysis showed that K=-0.110 (p>0.05) showed that there was no congruence between the results of chest x-ray examination of lung lesions before and after therapy (improved or not) with sputum conversion

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胸部 X 射线上痰液转化与强化期病变区消退的同步性肺结核治疗预后的决定因素

背景：肺结核（TB）是由结核分枝杆菌引起的一种慢性传染病。肺结核的确诊有两种方法，即细菌学诊断（如果发现 AFB 痰（+））和临床诊断（如果发现 BTA 痰（-），但胸部 X 光检查为（+）肺结核）。目的：确定胸片上痰液转化和强化期病变广泛消退的排列，这决定了肺结核治疗的预后。研究方法：研究设计为回顾性队列分析和回顾性纵向研究设计。数据来自泗水 RSI Jemursari 肺病综合诊所接受过 6 个月或更长时间治疗的肺结核患者的医疗记录。样本数量为 48 名患者，年龄在 41-60 岁之间。所有这些肺结核患者均为涂片阳性（BTA+）。治疗前后均进行了 X 光检查。结果：使用 Wilcoxon Signed Rank 检验对治疗前后肺部病变等级的差异进行分析，结果显示 p = 0.003（p 0.05），50% 的患者、47.9% 的患者肺部病变和痰液转阴情况有所改善，2.1% 的患者肺部病变和痰液转阴情况没有改善。其余 50%患者的肺部病变修复和痰液转化结果不一致。结论Kappa 系数分析结果显示，K=-0.110（P>0.05）表明，治疗前后肺部病变胸部 X 光检查结果（改善或未改善）与痰液转阴之间不一致

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Medical and Health Science Journal

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