肺结核与慢性阻塞性肺疾病临床分析

Clinical Analysis of Pulmonary Tuberculosis Accompanied with COPD

目的评价在新疆地区由肺结核病引起的胸部影像学改变与气流受限的关系。方法对于笔者医院1600例患者进行了慢性阻塞性肺疾病（COPD）的流行病学调查，并对于有肺结核病史并引起胸部影像学改变并且出现慢性阻塞性肺疾病的患者进行分析。结果笔者分析了参与调查的1600例患者，所有患者年龄在40岁以上，并进行了肺功能检查及胸部CT检查，明确气流受限的标准为扩张后FEV，／FVC〈70％；480例患者有既往肺结核感染的影像学改变，480例患者中156例患者有气流受限；在无肺结核所致胸部影像学改变的患者的气流受限的患病率只有9．1％；根据胸部影像学变化造成的气流受限的未校正的比值比为3．788（95％CI：2．544～5．762）。结论肺结核所致的胸部影像学改变与气道阻塞有关。

Objective To evaluate the association between the radiologic changes by tuberculosis and airflow obstruction in Xin- Jiang. Methods A COPD prevalence survey was conducted. We compared the prevalence of airflow obstruction according to the presence of the radiologic change by the tuberculosis. Results We analyzed 1600 subjects who participated in COPD survey in People＇s Hospital of Xinjiang Uygur Autonomous. All subjects were older than 40 years and took the spirometry and chest Computerized Tomography. We defined the airflow obstruction as FEV1/FVC 〈 70% after bronchodilator. A total of 492 （30.7%） subjects showed airflow obstruction. A total of 480 （30.0%） subjects showed CT change by tuberculosis. Among these 480 subjects, 156 （32.5%） had airflow obstruction. For the subjects without radiologic change by tuberculosis, the prevalence of airflow obstruction was only 9.1%. The unadjusted odds ratio for airflow obstruction according to the radiologic change was 3. 788 （95 % C1 ： 2. 544 - 5. 642 ）. Conclusion The radiologic change by tuberculosis was associated with airflow obstruction.