结核后支气管扩张症的临床特征分析OA

Objective:To investigate the clinical characteristics of post-tuberculosis bronchiectasis(PTBE)to provide a basis for individualized diagnosis and treatment.Methods:A cross-sectional study was conducted.A total of 350 patients with stable bronchiectasis from Longhua Hospital Affilicated to Shanghai University of Traditional Chinese Medicine between July 2021 and December 2024 were enrolled.According to the history of pulmonary tuberculosis,patients were divided into a post-tuberculosis bronchiectasis group(PTBE group,n=86)and a non-post-tuberculosis bronchiectasis group(NPTBE group,n=264).Demographic characteristics,acute exacerbations,pulmonary function,chest CT findings,colonization with pseudomonas aeruginosa,clinical symptoms and related scores,blood routine tests,albumin levels,and lymphocyte subsets were compared between the two groups.Results:The median disease duration in the PTBE group was 20.00(15.00,23.00)years,significantly longer than the 11.00(6.75,15.00)years in the NPTBE group(Z=-9.554,P＜0.001).The proportion of patients with≥3 acute exacerbations within one year was 48.84％(42/86)in the PTBE group,significantly higher than 18.94％(50/264)in the NPTBE group(x2=29.926,P＜0.001).The hospitalization rate due to acute exacerbations within one year was 51.16％(55/86)in the PTBE group,significantly higher than 27.65％(73/264)in the NPTBE group(x2=16.113,P＜0.001).The proportion of patients with involvement of ≥3 lung lobes was 84.88％(73/86)in the PTBE group,significantly higher than 55.30％(146/264)in the NPTBE group(x2=24.237,P＜0.001).The forced vital capacity percent predicted(FVC％pred)was 0.66±0.08 in the PTBE group,significantly lower than 0.70±0.09 in the NPTBE group(t=3.968,P＜0.001).The proportion of patients with a forced expiratory volume in one second percent predicted(FEV1％pred)＜70％was 48.84％(42/86)in the PTBE group,significantly higher than 27.65％(73/264)in the NPTBE group(x2=13.197,P＜0.001).The rate of chronic Pseudomonas aeruginosa colonization was 62.79％(54/86)in the PTBE group,significantly higher than 29.17％(77/264)in the NPTBE group(x2=31.321,P＜0.001).The incidence of hemoptysis was 18.60％(16/86)in the PTBE group,significantly higher than 6.82％(18/264)in the NPTBE group(x2=10.275,P=0.001).Conclusion:Patients with post-tuberculosis bronchiectasis present with a longer disease duration,more extensive pulmonary structural destruction,higher risk of chronic Pseudomonas aeruginosa colonization,and more frequent acute exacerbations.Early and intensive anti-infective therapy and pulmonary rehabilitation interventions are recommended for these patients..