PURPOSE: Pulmonary sequelae of tuberculosis are characterized by bronchovascular distortion, bronchiectasis, emphysematous changes, and fibrotic bands. Little is known of effects of treated pulmonary tuberculosis on lung function. The aim of the study was to evaluate the prevalence of pulmonary function abnormalities in patients who had been treated for pulmonary tuberculosis.
METHODS: In consecutive 217 patients (between the ages of 20 and 82 years) who were observed at the local dispensary spirometry and plethysmography were performed at least two years after treatment.
RESULTS: Pulmonary function results were normal in 118 of 217 (54,4%) patients. Pulmonary impairment was present in 99 (45,6%) patients including 70 (32,3%) patients with airway obstruction (FEV1/FVC <0.7 and TLC >80% predicted), 20 (9,2%) patients with restrictive pattern (TLC<80% predicted and FEV1/FVC ≥0.7) and 9(4,1%) patients with combined pattern (TLC<80% predicted and FEV1/FVC <0.7). Of 217 patients, 78 (35.9%) had low pulmonary function (FEV1 < 80% predicted). According to ATS/ERS criteria we classified 9,7% of subjects as having mild impairment, 16,5% of subjects as having moderate impairment, and 9,7% of subjects as having severe impairment. The prevalence of low pulmonary function in patients aged 40 and older and in younger patients was 41,6% and 13,6%, respectively (p<0,01). The prevalence of low pulmonary function in patients with culture-positive and culture-negative pulmonary tuberculosis in the past was 44,7% and 20,2%, respectively (p<0,01). The prevalence of low pulmonary function in patients with two or more episodes of tuberculosis and in patients with one episode was 63,3% and 30,9%, respectively (p<0,01). We did not find influence of gender, smoking on the prevalence of low pulmonary function.
CONCLUSIONS: A microbiological cure is not the end of illness. Tuberculosis is associated with frequent pulmonary impairment which was variable, ranging from mild to severe.
CLINICAL IMPLICATIONS: This supports performance of pulmonary function tests in the course of treatment and after a cure.
DISCLOSURE: The following authors have nothing to disclose: Mikhail Chushkin, Sergey Yartsev, Dmitriy Zhutikov, Elena Bogorodskaya, Sergey Smerdin
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