Clinical Characteristics And Drug Resistance Analysis Of Pulmonary Tuberculosis Complicated With COPD In Northern Henan

BackgroundTuberculosis is a common infectious disease and one of the ten leading causes of human death.Chronic obstructive pulmonary disease（COPD）is the third leading cause of death^[1].Pulmonary tuberculosis and COPD have common risk factors^[2].There are reports of tuberculosis-associated chronic obstructive pulmonary disease（TOPD）confirmed by histology^[3].Moreover,drug-resistant tuberculosis has the characteristics of drug resistance,infectivity,low cure rate and high mortality,which has great harmfulness.Therefore,patients with pulmonary tuberculosis complicated with COPD and their drug resistance have attracted widespread attention.Our hospital is a provincial-level tertiary hospital,most patients were from northern Henan.Therefore,patients with pulmonary tuberculosis in our hospital were selected as the research object,representing the characteristics and drug resistance of patients in northern Henan.ObjectivesTo investigate the clinical characteristics of Pulmonary tuberculosis complicated with COPD,summarize its drug resistance and analyze its causes,provide scientific basis for clinical rational treatment.Methods7803 cases of pulmonary tuberculosis over 40 years old hospitalized in our hospital from July 2016 to March 2020,according to whether the merger of COPD will be divided into two groups,including single tuberculosis as the control group（n=7248）,COPD amalgamate tuberculosis as the observation group（n=555）.According to the occurrence of drug resistance,they were divided into three subgroups:tuberculosis drug resistance group（n=320）,tuberculosis combined with COPD drug resistance group（n=35）and tuberculosis combined with COPD sensitive group（n=520）.Apply SPSS 22.0 statistics software.Measurement information expressed in x±s,Comparison between groups using t test;Count data usingχ2 test or rank sum test.The Logistic model was used to analyze the high risk factors of tuberculosis combined with COPD and to calculate the ratio of each factor（OR）and 95%confidence interval（CI）.P<0.05 was statistically significant.Comparing the difference of anti-tuberculosis drug resistance and its clinical characteristics in patients with pulmonary tuberculosis complicated with COPD drug resistance group and tuberculosis resistant group,Analysis of risk factors for drug resistance to tuberculosis in patients with tuberculosis complicated with COPD.Results1.Clinical characteristics:（1）Gender.Compared with the control group,the proportion of middle-aged and elderly males was 70.6%（5117/7248）,and the observation group was78.2%（434/555）.There was significant difference between the two groups（P<0.05）.（2）Tuberculosis relapse.The recurrence rate of observation group was 14.89%（83/555）higher than that of control group 6.84%（496/7248）,P<0.05;（3）Clinical symptoms.The afternoon low fever,malnutrition and hemoptysis proportions of chest pain in the observation group were higher than those in the control group（P<0.05）.（4）The drug resistance rate of the observation group was 6.36%（35/550）,which was significantly higher than 4.42%（320/7248）of the control group（P<0.05）.2.Drug resistance analysis.Pulmonary tuberculosis with COPD drug resistance group of 35 cases,simple pulmonary tuberculosis drug resistance group of 320 cases.Mono-drug resistance rate was 3.8%（12/320）in simple pulmonary tuberculosis group and 10.9%（35/320）in pulmonary tuberculosis combined with COPD group.Mono-drug resistance rate was 42.9%（15/35）in pulmonary tuberculosis combined with COPD group and 22.9%（8/35）in pulmonary tuberculosis combined with COPD group.3.Influencing factors.Single factor analysis showed that the proportions of malnutrition,diabetes,pulmonary cavity formation and tuberculosis treatment history（retreatment）in the drug-resistant group of pulmonary tuberculosis complicated with COPD were higher than those in the sensitive group of pulmonary tuberculosis complicated with COPD（P<0.05）.At the same time,multivariate logistic regression analysis showed that diabetes,tuberculosis treatment and age,with more complications were risk factors for drug resistance to tuberculosis（P<0.05）.Conclusions1.Compared with patients with simple pulmonary tuberculosis,mono-drug resistance and rifampicin resistance were higher in patients with pulmonary tuberculosis complicated with COPD;2.Age,retreatment,diabetes and the number of complications are the risk factors of anti-tuberculosis drug resistance in pulmonary tuberculosis complicated with COPD.