中国全科医学2026，Vol.29Issue(5)：606-611,6.DOI:10.12114/j.issn.1007-9572.2024.0678
结核性支气管扩张症患者转归情况及其影响因素研究
Analysis on Prognosis and Influencing Factors in Patients with Post-tuberculosis Bronchiectasis
摘要
Abstract
Background Post-tuberculosis bronchiectasis is one of the significant sequelae of tuberculosis.At present,the specific impact on the prognosis of patients with tuberculous bronchiectasis has not been fully understood.Objective To understand the prognosis and influencing factors of patients with post-tuberculosis bronchiectasis and provide scientific basis for improving the prognosis of these patients.Methods A total of 337 patients with post-tuberculosis bronchiectasis who were hospitalized in Guiyang Public Health Treatment Center from April 2023 to April 2024 were selected.Telephone follow-up was conducted on their prognosis 6 months after discharge,and they were divided into the good prognosis group and the poor prognosis group.The random forest model and LASSO regression were used to screen and analyze the influencing factors of the prognosis and rank their importance.Results The incidence of poor prognosis in 337 patients with post-tuberculosis bronchiectasis was 41.2%(139/337).There were statistically significant differences in age,educational level,BMI,previous smoking,the percentage of forced expiratory volume in one second(FEV1%pred),alveolar lavage,combined chronic pulmonary heart disease,combined chronic obstructive pulmonary disease,combined hypertension,Pseudomonas aeruginosa infection,post-discharge smoking,post-discharge drinking,lack of daily exercise,living alone,non-compliance with medication as prescribed,and levels of interleukin-6(IL-6)and high-sensitivity C-reactive protein(hs-CRP)at discharge between the two groups(P<0.05).LASSO regression model analysis was conducted on the variables with significant differences in the univariate analysis,and a total of 9 variables were selected.The results of the random forest model showed that the order of importance of each influencing factor was as follows:non-compliance with medication as prescribed,post-discharge smoking,lack of daily exercise,educational level,combined chronic pulmonary heart disease,discharge IL-6,age,post-discharge drinking,and living alone.The results of the multivariate Logistic regression analysis showed that non-compliance with medication as prescribed(OR=8.394,95%CI=3.323-21.203),post-discharge smoking(OR=5.294,95%CI=2.313-12.116),lack of daily exercise(OR=4.555,95%CI=2.206-9.406),combined chronic pulmonary heart disease(OR=4.331,95%CI=2.012-9.323),discharge IL-6(OR=1.054,95%CI=1.018-1.091),and age≥80 years(OR=5.246,95%CI=1.097-25.077)were risk factors for the prognosis of patients with post-tuberculosis bronchiectasis(P<0.05),while primary education(OR=0.358,95%CI=0.143-0.898)and secondary education(OR=0.202,95%CI=0.074-0.554)were protective factors for the prognosis of patients with post-tuberculosis bronchiectasis(P<0.05).Conclusion Patients with post-tuberculosis bronchiectasis have a relatively high incidence of poor prognosis.Non-compliance with medication as prescribed,smoking after discharge,lack of daily exercise,combined chronic obstructive pulmonary disease,IL-6 at discharge,age≥80 years old,and educational level are important influencing factors for tuberculous bronchiectasis.Targeted measures can be taken based on these influencing factors.关键词
结核性支气管扩张症/转归/影响因素/随机森林模型Key words
Post-tuberculosis bronchiectasis/Prognosis/Influencing factors/Random forest model分类
医药卫生引用本文复制引用
汪雪,杨程茗,王子云,周忠..结核性支气管扩张症患者转归情况及其影响因素研究[J].中国全科医学,2026,29(5):606-611,6.基金项目
贵阳市科技局计划项目(筑科合同[2022]4-9号) （筑科合同[2022]4-9号）
