低肺领域结核的微生物学方面和临床影响:秘鲁的一项观察性队列研究
Qi Tan1, Chuan-Chin Huang2, Roger Calderon3
1Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
概括
下肺领域结核病 (LLF TB) 通常是晚期诊断的,并且与Mycobacterium结核病系2有关. 患有LLF结核病的患者在治疗期间症状改善的速度较慢.
科学领域:
- 肺部医学 肺部医学
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 下肺领域结核病 (LLF TB) 经常被误诊,导致治疗延迟,特别是在资源有限的环境中.
- 非典型的LLF结核病表现可以模仿其他肺部疾病,可能增加结核病的传播和死亡率.
研究的目的:
- 确定与LLF结核病相关的微生物决定因素.
- 评估LLF结核病患者的治疗反应,以优化护理策略.
主要方法:
- 在秘鲁利马进行了一项观察性队列研究,其中包括患有微生物学确认的肺结核 (PTB) 的成年人.
- 全基因组测序被用来确定Mycobacterium结核病 (MTB) 血统.
- 评估了圣乔治呼吸道问卷 (SGRQ) 分数的变化和最终治疗结果.
主要成果:
- 在1316名PTB患者中,LLF结核病被诊断为6%.
- 在LLF结核病患者中,涂抹阴性 (aOR=2.04) 和感染MTB Lineage 2 (aOR=1.95) 的可能性更高.
- 患有LLF结核病的患者在2个月后SGRQ得分的改善较小 (调整后差异=6.29),但显示出更好的最终结果的趋势.
结论:
- 在常规测试中,LLF结核病与唾液阴性以及MTB Lineage 2感染有关.
- 与上肺病变患者相比,患有LLF结核病的患者在治疗早期表现出较少的临床改善.
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