Monitoring of pulmonary function in patients with active tuberculosis during anti-tuberculosis treatment

doi:10.3969/j.issn.2096-8493.2020.01.009

Abstract

Abstract:

Objective To observe changes of pulmonary function of patients with active tuberculosis as the treatment progresses. Methods Data were collected on 628 patients with active tuberculosis admitted to Hunan Chest Hospital from January 2018 to August 2019. 249 patients were included in the analysis according to inclusion and exclusion criteria. Pulmonary functions of patients were measured before treatment,at the end of the first month, at the end of intensive period and at the end of treatment. Overall lung function, pulmonary ventilation function, diffusing capacity, lung volume, and airway resistance at those four time points were compared. Results The abnormal rate of overall lung function assessment,pulmonary ventilation function, diffusion function, lung volume, respiratory impedance results before treatment were 91.97% (229/249), 67.07% (167/249), 48.19% (120/249), 71.89% (179/249) and 34.14% (85/249) respectively. As the treatment went on, the abnormal rate dropped to 77.11% (192/249), 51.81% (129/249), 30.12%(75/249), 44.18% (110/249), 23.69% (59/249) at the end of the treatment. Differences were statistically significant (χ²=25.434, 25.255, 37.227, 60.238, 27.153, all P=0.000). Patients with restrictive and mixed ventilation dysfunction decreased from 27.31% (68/249) and 12.85% (32/249) before treatment to 11.65% (29/249) and 6.83% (17/249) at the end of treatment, differences were statistically significant ( $χ trend 2$ =39.222, 16.068; P=0.000, 0.001). Patients with obstructive ventilation dysfunction before treatment were 26.91% (67/249), at the end of treatment it increased to 33.33% (83/249), the difference was not statistically significant ( $χ trend 2$ =1.233, P=0.745). Conclusion Pulmonary tuberculosis patients often suffers with lung function damage. With the progress of treatment, lung function damage has been repaired to varying degrees, but the abnormal rate of lung function is still high at the end of the treatment course. The restrictive and mixed pulmonary ventilation dysfunction were improved significantly at the end of treatment, while obstructive ventilation dysfunction persisted.

Key words: Tuberculosis, pulmonary, Drug therapy, Episode of care, Pulmonary function tests, Recovery of function, Outcome and process assessment (health care)

WANG Chun-ting, LI Ya-qi, MI Yan, MO Nian-chun, LIU Hong-yan, LE Xing, ZHOU Li, WU Bi-feng, HAN Shi-yun, BAI Li-qiong, ZHANG Chuan-fang. Monitoring of pulmonary function in patients with active tuberculosis during anti-tuberculosis treatment[J]. Journal of Tuberculosis and Lung Disease , 2020, 1(1): 39-44. doi: 10.3969/j.issn.2096-8493.2020.01.009

Figures/Tables 3

疗程	总体状态评估异常
疗程	例数	异常率(%)	例数	异常率(%)	例数	异常率(%)	例数	异常率(%)	例数	异常率(%)
治疗前	229	91.97	167	67.07	120	48.19	179	71.89	85	34.14
1个月末	216	86.75	154	61.85	107	42.97	154	61.85	83	33.33
强化期末	208	83.53	146	58.63	103	41.37	130	52.21	59	23.69
疗程末	192	77.11	129	51.81	75	30.12	110	44.18	59	23.69
$χ 趋势 2$ 值		25.434		25.255		37.227		60.238		27.153
P值		0.000		0.000		0.000		0.000		0.000

疗程	FVC (%, $x ˉ$ ±s)	FEV₁ [%, M(Q₁, Q₃)]	FEV₁/FVC [%, M(Q₁, Q₃)]	TLC (%, $x ˉ$ ±s)	RV [%, M(Q₁, Q₃)]	RV/TLC [%, M(Q₁, Q₃)]	D_LCO (%, $x ˉ$ ±s)	Z₅ [%, M(Q₁, Q₃)]	R₅ [%, M(Q₁, Q₃)]	R₂₀ [%, M(Q₁, Q₃)]
治疗前	83.29± 19.19	79.08 (64.85, 92.00)	94.95 (86.51, 102.66)	81.17± 15.26	95.50 (80.10, 115.35)	119.18 (101.49, 137.65)	80.28± 17.21	126.00 (109.50, 149.50)	118.00 (102.50, 141.00)	129.00 (111.50, 149.50)
1个月末	86.67± 17.84^a	84.00 (70.50, 94.00)^b	95.50 (87.10, 103.26)	83.91± 14.81^a	95.20 (82.03, 110.30)	114.11 (100.62, 130.40)	83.05± 17.01^a	118.00 (103.00, 145.00)^b	112.00 (95.00, 135.50)^b	126.00 (106.00, 142.50)^b
强化期末	89.15± 17.01^c,d	86.00 (75.00, 95.00)^e,f	95.55 (87.81, 102.98)	85.65± 12.93^c,d	95.40 (83.15, 112.45)	112.20 (98.68, 126.41)	84.83± 16.35^c,d	117.00 (103.00, 140.00)^e	108.00 (95.00, 132.50)^e	123.00 (106.50, 141.00)^e
疗程末	92.69± 16.41^g,h,i	89.00 (78.65, 98.89)^j,k,l	95.49 (87.13, 102.37)	88.83± 12.98^g,h,i	94.40 (81.60, 108.96)^k,l	106.56 (94.71, 122.22)^j,k,l	89.44± 16.97^g,h,i	114.00 (97.00, 135.00)^j,k,l	105.00 (87.00, 126.50)^j,k,l	116.00 (97.00, 136.50)^j,k,l
统计量	117.122^m	282.263ⁿ	1.100ⁿ	66.400^m	12.372ⁿ	96.118ⁿ	70.413^m	120.459ⁿ	106.438ⁿ	101.474ⁿ
P值	0.000	0.000	0.777	0.000	0.006	0.000	0.000	0.000	0.000	0.000

疗程	阻塞性通气功能障碍		限制性通气功能障碍		混合性通气功能障碍
疗程	例数	异常率(%)	例数	异常率(%)	例数	异常率(%)
治疗前	67	26.91	68	27.31	32	12.85
1个月末	69	27.71	56	22.49	29	11.65
强化期末	76	30.52	52	20.88	18	7.23
疗程末	83	33.33	29	11.65	17	6.83
$χ 趋势 2$ 值		1.233		39.222		16.068
P值		0.745		0.000		0.001

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