■肺结核(TB)后的肺动脉高压(PH)通常不包括在引起PH的慢性肺部疾病(第3组PH)中,很少有数据支持纳入。
■确定完成TB治疗的成年人群中PH的患病率。
■这种单中心,横断面研究仅包括首次记录结核病发作的患者,和谁是在下半年的治疗或最近完成治疗。使用经胸超声心动图评估PH。问卷调查完成,进行肺活量测定和6分钟步行试验.
■招募了100名患者,平均年龄为37.1岁,其中58%为男性,46%为HIV阳性。自开始TB治疗以来的中位时间为22周。测量的右心室收缩压(RVSP)的平均值(标准偏差)为23.6(6.24)mmHg。一名参与者患有PH(定义为RVSP≥40mmHg;95%置信区间(CI)0.0-3.0),另有3名参与者患有可能的PH(RVSP≥35且<40mmHg),合并PH患病率为4%(95%CI0.2-7.8)。在98例患者中,有13.3%的患者在肺活量测定中发现了气流阻塞,而25.5%的人用力肺活量下降。RVSP或PH/可能的PH与性别之间没有关联,年龄,艾滋病毒状况,全身性高血压,肺活量测量或6分钟步行距离。吸烟状况与RVSP相关,但不存在PH/可能的PH。
在这项初步研究中,主要是年轻患者完成了首次结核病发作的治疗,PH的患病率很高。需要进行更大规模和更详细的研究。
■这项研究补充了什么。在100名初发结核病(TB)的成年患者中,他们在治疗结束时接受了超声心动图检查,以确定肺动脉高压(PH)的患病率。1(1%)具有PH,另外3(3%)具有可能的PH。性别之间没有关联,年龄,艾滋病毒状况,肺功能或6分钟步行距离和PH的存在。该研究增加了人们对结核病与肺血管疾病之间关系的认识。它表明,即使是在门诊治疗的初发结核病的年轻人群,治疗完成后,PH的患病率很高。对调查结果的影响。鉴于每年有1060万人感染结核病,PH病例的全球绝对负担可能很高,但迄今为止尚未得到重视。在这一领域迫切需要进一步的工作。
UNASSIGNED: Pulmonary hypertension (PH) after tuberculosis (TB) is typically not included among the chronic lung diseases causing PH (group 3 PH), with few data available to support the inclusion.
UNASSIGNED: To determine the prevalence of PH in an adult population completing TB treatment.
UNASSIGNED: This single-centre, cross-sectional study only included patients with their first documented episode of TB, and who were in the second half of treatment or had recently completed treatment. PH was assessed using transthoracic echocardiography. Questionnaires were completed, and spirometry and a 6-minute walk test were performed.
UNASSIGNED: One hundred patients were enrolled, with a mean age of 37.1 years, of whom 58% were male and 46% HIV positive. The median time since initiation of TB treatment was 22 weeks. The mean (standard deviation) measured right ventricular systolic pressure (RVSP) was 23.6 (6.24) mmHg. One participant had PH (defined as RVSP ≥40 mmHg; 95% confidence interval (CI) 0.0 - 3.0) and a further 3 had possible PH (RVSP ≥35 and <40 mmHg), with a combined PH prevalence of 4% (95% CI 0.2 - 7.8). Airflow obstruction on spirometry was found in 13.3% of 98 patients, while 25.5% had a reduced forced vital capacity. There was no association between RVSP or PH/possible PH and sex, age, HIV status, systemic hypertension, spirometry measurements or 6-minute walking distance. Smoking status was associated with RVSP, but not with the presence of PH/possible PH.
UNASSIGNED: There was a significant prevalence of PH in this preliminary study of predominantly young patients completing treatment for a first episode of TB. Larger and more detailed studies are warranted.
UNASSIGNED: What the study adds. Of 100 adult patients with their first episode of tuberculosis (TB) who underwent echocardiograms near the end of treatment completion to determine the prevalence of pulmonary hypertension (PH), 1 (1%) had PH and a further 3 (3%) had possible PH. There was no association between sex, age, HIV status, lung function or 6-minute walking distance and the presence of PH. The study adds to the growing awareness of the association of TB with pulmonary vascular disease. It shows that even in a young population with a first episode of TB treated in an ambulatory setting, there is a significant prevalence of PH on treatment completion.Implications of the findings. Given that 10.6 million people acquire TB annually, the absolute global burden of cases with PH is likely to be high, but is underappreciated to date. Further work is urgently needed in this field.