临床,放射学和微生物谱后结核与非结核性支气管扩张患者在印度中部三级保健中心:回顾性研究。

Ashok Arbat, Diti Gandhasiri, Sweta Chourasia, Gauri Gadge, Parimal Deshpande, Swapnil Bakamwar
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引用次数: 0

摘要

本研究旨在回顾性研究和比较印度中部地区结核后(PTB)和非结核性(NTB)支气管扩张患者的特征。材料和方法:行支气管镜检查的支气管扩张患者通过高分辨率计算机断层扫描(CT)进行诊断,并在临床、放射学、微生物学和肺活量测定的基础上评估PTB与NTB。结果:90例患者平均年龄为52.54±16.33岁。患者以60岁以上年龄组居多。主要症状为咳嗽(78例,占86.66%)、呼吸困难(65例,占72.22%)、发热(44例,占48.88%)。男性人群中PTB组所占比例更高(n= 26、59.09% vs. n= 18、40.91%,p= 0.387)。双侧和单侧支气管扩张主要存在于NTB (n= 34, 73.91%)和PTB (n= 18;分别为40.91%)。所有患者中最常见的支气管扩张的影像学表现为囊性型(n= 52, 89.66%);然而,PTB组的静脉曲张发生率明显高于NTB组(n= 8,18.18% vs. n= 2,4.35%, p= 0.037)。NTB组体重指数(21.79±4.93 kg/m2)显著高于PTB组(18.89±3.60 kg/m2), p值为0.004。PTB组支气管肺泡灌洗(BAL)中铜绿假单胞菌感染的比例(n= 12, 27.27%)高于NTB组(n= 10, 21.74%)。PTB组22.73% (n= 10)的患者出现TB再激活,NTB组8.70% (n= 04)的患者出现TB再激活。肺活量测定方面,NTB组出现阻塞性的患者比例明显高于PTB组(30.43% vs. 6.82%, p= 0.004)。结论:支气管扩张最突出的潜在原因是PTB,单侧静脉曲张亚型在胸部CT上更为常见。再次感染是支气管扩张患者病情加重的主要原因,假单胞菌是最常见的感染因子。我们的研究也有助于印度支气管扩张患者的数据池。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical, radiological and microbiological profile of post-tuberculosis versus nontuberculosis bronchiectasis patients at a tertiary care centre of Central India: A retrospective study.

Introduction: This study aimed to examine and compare the characteristics of post tuberculosis (PTB) and non-tuberculosis (NTB) bronchiectasis patients of Central India retrospectively.

Materials and methods: Bronchiectasis patients who underwent bronchoscopy were diagnosed by high resolution computed tomography (CT) scans, and PTB versus NTB were assessed clinically, radiologically, microbiologically and on the basis of spirometry.

Result: Mean age of the total 90 patients was 52.54 ± 16.33 years. Maximum patients were in the age group above 60 years old. Overall major symptoms were cough (n= 78, 86.66%), dyspnea (n= 65, 72.22%) and fever (n= 44, 48.88%). The proportion of the male population was more in the PTB group (n= 26, 59.09% vs. n= 18, 40.91%, p= 0.387). Bilateral and unilateral bronchiectasis were predominantly present in NTB (n= 34, 73.91%) and PTB (n= 18; 40.91%) respectively. The most common radiological variant of bronchiectasis found in all patients was a cystic type (n= 52, 89.66%); however, the presence of varicose was significantly higher in PTB than NTB group (n= 8, 18.18% vs. n= 2, 4.35%, p= 0.037). Body mass index in NTB (21.79 ± 4.93 kg/m2) was significantly higher than that of PTB group (18.89 ± 3.60 kg/m2) with p-value of 0.004. The proportion of patients with Pseudomonas aeruginosa infection in bronchoalveolar lavage (BAL) of PTB group (n= 12, 27.27%) was more than the NTB group (n= 10, 21.74%). 22.73% (n= 10) patients had a reactivation of TB in the PTB and 8.70% (n= 04) in NTB group. On spirometry, the proportion of patients with obstructive findings was significantly higher in NTB than PTB group (30.43% vs. 6.82%, p= 0.004).

Conclusions: The most prominent underlying cause of bronchiectasis was PTB, with unilateral, varicose subtype being significantly more prevalent on thorax CT. Re-infection was the primary cause of exacerbations in bronchiectasis patients, with Pseudomonas being the most common infectious agent. Our study also contributes to the data pool on bronchiectasis patients in India.

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