结核病后的肺病:解决政策差距
Chase Yarbrough1,2,3,4, Michael Miller1,4, Mosala Zulu3
1Harvard Medical School, Boston, Massachusetts, United States of America.
PLOS global public health
|September 5, 2024
概括
结核病后肺部疾病 (PTLD) 影响了结核病治疗后超过一半的患者,导致慢性损伤. 目前的结核病政策忽视了PTLD,需要综合诊断和护理策略.
科学领域:
- 公共卫生 公共卫生
- 呼吸系统医学 呼吸系统医学
- 传染性疾病 传染性疾病
背景情况:
- 结核病 (TB) 治疗可以治愈感染,但往往会导致长期功能障碍.
- 结核病后肺部疾病 (PTLD) 影响了超过50%的完成结核病治疗的患者,这代表了全球健康负担.
- 在目前的国际和国家结核病政策和指导方针中,PTLD在很大程度上没有得到解决,尽管其患病率和发病率很高.
研究的目的:
- 突出PTLD作为结核病的长期并发症的重大负担.
- 倡导将PTLD纳入全球结核病政策和临床指南.
- 强调需要在PTLD诊断和管理方面制定标准.
主要方法:
- 审查当前的结核病治疗结果和患者发病率.
- 分析现有的国际和国家结核病政策和指导方针.
- 评估目前对结核病后慢性呼吸系统障碍的治疗方法.
主要成果:
- 在完成结核病治疗的患者中,超过一半的患者会发展为PTLD,这是慢性呼吸系统功能障碍的主要原因.
- 在主要的结核病政策讨论和临床管理指南中,PTLD显然缺席.
- 缺乏用于PTLD诊断和护理的确立的临床标准.
结论:
- 迫切需要明确的临床标准来诊断和管理PTLD.
- 所有完成结核病治疗的患者都应进行PTLD查.
- 将PTLD整合到慢性护理中,包括获得吸入器和家庭氧气,至关重要. 像全球基金这样的资助者应该在他们的战略和资金中优先考虑PTLD.
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