| Objective:Bronchiectasis is a chronic inflammatory irreversibly pulmonary disease accompanied by cough,sputum production and recurrent respiratory infection.Just like other etiologies such as idiopathic,the subsequent destruction of tuberculosis to the lungs takes quite a share in the etiology of bronchiectasis in China.We ought to evaluate the clinical characteristics of post-tuberculosis bronchiectasis patients as well as its applicability to the two bronchiectasis severity score systems.Method:596 bronchiectasis patients including 101 post-tuberculosis bronchiectasis patients enrolled in Shanghai Pulmonary Hospital between January 2011 and December 2012 were included in this study.We collected the data about anthropometry、clinical symptoms、disease frequency 、 serum biomarkers 、 colonization with organisms(Pseudomonas aeruginosa or other organisms)、radiographic manifestationslung and function indices.Also,the prognosis included mortality,readmission,and exacerbation outcomes were collected and analyzed within a follow-up period with a median length of 48 months(interquartile range 43-54 months).We performed statistical analyses with SPSS 22.0 and MedCalc 15.6.Result1.We compared the differences in baseline and prognosis between these two groups.There only presented significant differences in terms of the hospital admission in follow-up years(P=0.046).The distribution of sex,daily smokers,purulent sputum,hemoptysis,onset of symptoms,length of hospitalization and serological index showed no difference(P>0.05).So did the mortality and exacerbations more than 2 times in follow-up per year.2.Relative to the Non-post-tuberculosis bronchiectasis group,the Post-tuberculosisbronchiectasis patients tended to be cylindrical(90.1% vs 66.9%,P<0.001),unilateral(49/52 vs 165/330,P=0.004)and involved more in right upper lobe(58.4% vs 32.1%,P<0.001).However,there were no significant difference between the numbers of involved lobes(2.4±1.08 vs 2.7±1.64,P=0.092).3.Similar to FACED score(P=0.045),Patients in Post-tuberculosis bronchiectasis were making up a larger share in worse FEV1%(P=0.033).However,this group of patients experienced less prior hospitalizations in BSI score(P<0.001).4.There were no significant differences in FACED score between two groups(P=0.608).However,according to BSI score,Post-tuberculosis bronchiectasis got lower points(P<0.001)and a higher percentage in mild level(P<0.001).5.It maintained consistent survival curves in Non-post tuberculosis patients and All patients,while graphs from FACED and BSI score showed there were large separation of the survival curves in Post-tuberculosis patients.6.The AUC for mortality were 0.81(95%CI 0.72-0.88)for the FACED,0.70(95%CI0.63-0.79)for the BSI in Post-tuberculosis patients.There were no statistical meaning between BSI and FACED score in mortality(P=0.2448).Furthermore,the predictive ability of two scoring systems in mortality seemed to be much better than in readmission and exacerbation.Conclusion:1.Post-tuberculosis bronchiectasis patients accounted for 16.9%.The indices about anthropometry,clinical symptoms,serum biomarkers and mortality showed no difference.2.Post-tuberculosis patients experienced less bilateral bronchiectasis,a higher frequency of right upper lobe involvement and showed the cylindrical type more often.3.Follow-up data indicated that FACED and BSI scores for severity calculation did not apply to post-tuberculosis patients.4.Both scoring systems were able to predict mortality in post-tuberculosis patients,but they did not predict readmission or exacerbation very well. |
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