肺结核后患者新感染冠状病毒时的呼吸评估

G.S. Balasaniants, Sumbul Z. Abdrakhmanova, L. T. Gilmutdinova, I. R. Farkhshatov
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摘要

背景:结核病后和冠状病毒感染后呼吸系统病变相互加重的可能性需要额外考虑。目的:研究新的冠状病毒感染恢复后肺结核后遗症患者的一些主观呼吸参数。材料与方法:研究包括两组:主组--14 名新冠状病毒感染后康复的已治愈肺结核患者,对比组--2020-2021 年入住 "Glukhovskaya "结核病疗养院的 52 名新冠状病毒感染后肺部残留变化患者。在入住疗养院时和一个月后,使用改良医学研究委员会(mMRC)和博格量表对呼吸急促的严重程度进行了评估。结果显示治疗前,主要组和对比组的 mMRC 量表分别为 1.5 ± 1.4 和 2.1 ± 0.2,博格量表分别为 1.5 ± 1.4 和 2.9 ± 0.2。根据 mMRC 量表,最初分别有 14.3% 和 11.5% 的肺结核患者和对比组患者没有抱怨气短,50% 的肺结核患者和 42.4% 的对比组患者将气短定义为严重气短。一个月后,肺结核患者的 mMRC 量表上出现了 3 或 4 点。在对比组中,3 分气喘减少了 11.2 倍,最常见的是 2 分气喘。根据博格量表,71.5%的肺结核患者呼吸困难最初被评估为 3 分。在对比组中,67.3%的患者呼吸困难为 3 级,11.5%的患者呼吸急促为 4-6 级。一个月后,肺结核组和对比组患者中出现轻度气喘的比例分别增加了 4.5 倍和 3.3 倍,出现 3 级气喘的频率分别减少了 5 倍和 3.9 倍。结论肺结核后的主要变化、吸烟和慢性阻塞性肺病在更大程度上决定了呼吸不适的严重程度,而非新感染冠状病毒的经历,但康复治疗可消除这些差异。建议对肺结核治愈患者的呼吸系统状况进行研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Breath assessment at with post-tuberculosis patients suffered new coronavirus infection
BACKGROUND: The possibility of mutual aggravation of post-tuberculosis and post-COVID respiratory pathologies requires additional consideration. AIM: To study some subjective breathing parameters at patients with post-tuberculosis pulmonary residual changes after a new coronavirus infection recovering. MATERIALS AND METHODS: The study included two groups: the main group — 14 patients with cured pulmonary tuberculosis, who had recovered from a new coronavirus infection, a comparison group — 52 patients with post-tuberculosis changes non-sick new coronavirus infection who were admitted to the tuberculosis sanatorium “Glukhovskaya” in 2020–2021. The severity of shortness of breath using the Modified Medical Research Council (mMRC) and Borg scales was assessed upon admission to the sanatorium and a month later. Results: The mMRC scale was 1.5 ± 1.4 and 2.1 ± 0.2 and the Borg scale was 1.5 ± 1.4 and 2.9 ± 0.2 before treatment respectively in the main group and the comparison group. According to the mMRC scale initially 14.3 and 11.5% of patients with pulmonary tuberculosis and the comparison group did not complain of shortness of breath and 50% of pulmonary tuberculosis patients and 42.4% of the comparison group defined it as severe. After a month there were 3 or 4 points on the mMRC scale among pulmonary tuberculosis patients. In the comparison group 3-point shortness of breath decreased by 11.2 times most often indicated shortness of breath with 2 score. According to the Borg scale dyspnea was initially assessed as 3 points at 71.5% pulmonary tuberculosis patients. In the comparison group 67.3% patients had grade 3 dyspnea and 11.5% noted 4–6 grade shortness of breath. After a month the proportion of patients with mild shortness of breath at the pulmonary tuberculosis and comparison groups increased by 4.5 and 3.3 times, respectively, and the frequency of 3-grade shortness of breath decreased by 5 and 3.9 times. CONCLUSIONS: Major post-tuberculosis changes, smoking and chronic obstructive pulmonary disease determine the severity of breathing discomfort to a greater extent than the experience of new coronavirus infection but rehabilitation treatment are leveled out these differences. It is advisable to study the state of the respiratory system at patients cured of pulmonary tuberculosis.
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