Analysis of clinical features and influence factors of patients with post-tuberculosis chronic pulmonary aspergillosis

doi:10.19871/j.cnki.xfcrbzz.2024.05.005

Abstract

Abstract: Objective To analyze the clinical characteristics and influence factors of chronic pulmonary aspergillosis (CPA) after tuberculosis to improve clinicians' understanding of post-tuberculosis CPA. Method From April 1, 2021, to April 30, 2023, 59 patients with chronic pulmonary aspergillosis who had a history of pulmonary tuberculosis were treated in the inpatient department of Third People's Hospital as the observation group (CPA group), and 118 patients with old pulmonary tuberculosis who did not have pulmonary fungal infection in the same period were selected as the control group (non-CPA group), and the clinical indicators of the two groups of patients were compared. The influence factors for the onset of CPA were analyzed by univariate and multivariate logistic regression analysis. Result Among 59 CPA patients, aspergillus fumigatus accounted for 80.5% (37/46). Univariate analysis showed that the proportion of lean patients in the CPA group was significantly higher than that in the non CPA group (P<0.05). The proportion of CPA combined with lung damage, chronic obstructive pulmonary disease, or bronchiectasis was higher in the non CPA group (P<0.05). The CPA group had a longer history of anti-tuberculosis treatment compared to the non CPA group (P<0.05). The proportion of patients with cough, sputum, hemoptysis, shortness of breath, or weight loss in the CPA group was higher than that in the non CPA group (P<0.05); The imaging manifestations of the CPA group were higher in terms of cavities, air crescent sign, consolidation, and mass shadows than those in the non CPA group; while the proportion of nodular shadows was lower than that in the non CPA group (P<0.05). The proportion of patients with hypoproteinemia, abnormal C-reactive protein, or erythrocyte sedimentation rate in the CPA group was higher compared to the non CPA group (P<0.05). The levels of hemoglobin and serum albumin in the CPA group were lower than those in the non CPA group (P<0.05). Multivariate logistic regression analysis showed that BMI (OR=0.865, 95% CI:0.767-0.976, P=0.018) and destroyed lung (OR=5.833, 95% CI:1.922-17.698, P=0.002) were independent influencing factors of post-tuberculosis CPA. Conclusion Aspergillus fumigatus is the main pathogen in post-tuberculosis CPA. The main symptoms include cough, sputum, hemoptysis, weight loss, and shortness of breath. Clinical manifestations include emaciation and hypoalbuminemia; elevated C-reactive protein and erythrocyte sedimentation rate. The pulmonary imaging lesions are mainly characterized by consolidation and mass shadows, with lesions characterized by cavities and air crescent signs as the main manifestations; Tuberculous lesions and low BMI are independent influence factors for chronic pulmonary aspergillosis after tuberculosis.

Key words: Post-tuberculosis lung disease, Chronic pulmonary aspergillosis, Clinical features, Influence factors

CLC Number:

R521

Zeng Jian, Wang Jin, Fang Mutong, Zeng Jianfeng, Lu Shuihua, Huang He. Analysis of clinical features and influence factors of patients with post-tuberculosis chronic pulmonary aspergillosis[J]. Electronic Journal of Emerging Infectious Diseases, 2024, 9(5): 25-30.

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