METHODS: Patients diagnosed with mediastinal LNTB via endosonography were evaluated retrospectively between October 2009 and December 2019. Multivariable logistic regression was applied to evaluate the risk factors associated with PR.
RESULTS: Of 9,052 patients who underwent endosonography during the study period, 158 were diagnosed with mediastinal LNTB. Of these, 55 (35%) and 41 (26%) concurrently had pulmonary tuberculosis and extrapulmonary tuberculosis other than mediastinal LNTB, respectively. Of 125 patients who completed anti-tuberculosis treatment, 21 (17%) developed PR at a median of 4.4 months after initiation of anti-tuberculosis treatment. The median duration of anti-tuberculosis treatment was 6.3 and 10.4 months in patients without and with PR, respectively. Development of PR was independently associated with age < 55 years (adjusted odds ratio [aOR], 5.72; 95% confidence interval [CI], 1.81-18.14; P = 0.003), lymphocyte count < 800/μL (aOR, 8.59; 95% CI, 1.60-46.20; P = 0.012), and short axis diameter of the largest lymph node (LN) ≥ 16 mm (aOR, 5.22; 95% CI, 1.70-16.00; P = 0.004) at the time of diagnosis of mediastinal LNTB.
CONCLUSIONS: As PR occurred in one of six patients with mediastinal LNTB during anti-tuberculosis treatment, physicians should pay attention to patients with risk factors (younger age, lymphocytopenia, and larger LN) at the time of diagnosis.
方法:2009年10月至2019年12月对通过超声内镜诊断为纵隔LNTB的患者进行回顾性评估。应用多因素logistic回归分析评价与PR相关的危险因素。
结果:在研究期间接受了内窥镜检查的9,052名患者中,158例诊断为纵隔型LNTB。其中,除纵隔LNTB外,55例(35%)和41例(26%)同时患有肺结核和肺外结核,分别。在完成抗结核治疗的125名患者中,21(17%)在开始抗结核治疗后的中位数为4.4个月发展为PR。在无PR和有PR的患者中,抗结核治疗的中位持续时间分别为6.3和10.4个月。分别。PR的发展与年龄<55岁独立相关(调整后的优势比[aOR],5.72;95%置信区间[CI],1.81-18.14;P=0.003),淋巴细胞计数<800/μL(aOR,8.59;95%CI,1.60-46.20;P=0.012),最大淋巴结短轴直径(LN)≥16mm(aOR,5.22;95%CI,1.70-16.00;P=0.004)在诊断纵隔LNTB时。
结论:在抗结核治疗期间,6例纵隔型LNTB患者中有1例发生PR,医生应该注意有危险因素的患者(年龄较小,淋巴细胞减少症,和较大的LN)在诊断时。