Abstract:Objective To analyze influencing factors for comorbid chronic obstructive pulmonary disease (COPD) among elderly patients with pulmonary tuberculosis, so as to provide a basis for early screening and intervention of COPD among elderly patients with pulmonary tuberculosis. Methods Elderly patients with pulmonary tuberculosis hospitalized in Anhui Chest Hospital from July 1, 2022 to June 30, 2024 were selected as the study participants. Data on gender, age, smoking, alcohol consumption, type of pulmonary tuberculosis treatment, pulmonary cavity and drug resistant tuberculosis were collected through the electronic medical record system of Anhui Chest Hospital, and COPD was diagnosed according to the Guidelines for the Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease (2021 Revision). A multivariable logistic regression model was used to analyze the influencing factors for comorbid COPD among elderly patients with pulmonary tuberculosis. Results A total of 180 elderly patients with pulmonary tuberculosis were included, including 142 males (78.89%) and 38 females (21.11%). The median age was 70.00 (interquartile range, 10.00) years. There were 93 smoking cases, accounting for 51.67%, 47 alcohol consumption cases, accounting for 26.11%, 44 cases presented with pulmonary cavities, accounting for 24.44%, 110 cases had drug resistant tuberculosis, accounting for 61.11%. There were 53 cases comorbid with COPD, accounting for 29.44%; 127 cases comorbid without COPD, accounting for 70.56%. There were statistically significant differences in gender, smoking, type of pulmonary tuberculosis treatment, pulmonary cavity and drug resistant tuberculosis between the comorbid COPD group and the comorbid without COPD group (all P<0.05). Multivariable logistic regression analysis showed that smoking (OR=8.953, 95%CI: 3.322-24.155), pulmonary cavity (OR=11.832, 95%CI: 4.186-33.401) and drug resistant tuberculosis (OR=7.487, 95%CI: 2.222-25.280) were associated with a higher risk of comorbid COPD. Conclusion The proportion of comorbid COPD among elderly patients with pulmonary tuberculosis was relatively high, and smoking, pulmonary cavity and drug resistant tuberculosis were the influencing factors for comorbid COPD among elderly patients with pulmonary tuberculosis.
[1] World Health Organization.World tuberculosis report 2025[R].Geneva:WHO,2025. [2] Farnia P,Velayati A A,Ghanavi J,et al.Tuberculosis:an ongoing global threat[M]//Proteins in Mycobacterium Tuberculosis:Functions and Therapeutic Advances.Cham:Springer Nature Switzerland,2026:1-31. [3] 夏梓浩,刘益宁,韦庆好,等.贵州省2017—2024年老年肺结核患者诊断总延迟及影响因素分析[J].中国热带医学,2026,26(4):568-575. [4] Jiang Z H,Dai Y Y,Chang J,et al.The clinical characteristics,treatment and prognosis of tuberculosis-associated chronic obstructive pulmonary disease:a protocol for a multicenter prospective cohort study in China[J].COPD,2024,19:2097-2107. [5] Amaral A F S,Coton S,Kato B,et al.Tuberculosis associates with both airflow obstruction and low lung function:BOLD results[J].Eur Respir J,2015,46(4):1104-1112. [6] Xing Z Z,Sun T Y,Janssens J P,et al.Airflow obstruction and small airway dysfunction following pulmonary tuberculosis:a cross-sectional survey[J].Thorax,2023,78(3):274-280. [7] WS 288—2017 肺结核诊断[S]. [8] Li H J,Zhou Y Y,Yu H H,et al.A preliminary screening tool for high-risk frailty in older adults patients with pulmonary tuberculosis[J].Clin Interv Aging,2025,20:57-68. [9] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组,中国医师协会呼吸医师分会慢性阻塞性肺疾病工作委员会.慢性阻塞性肺疾病诊治指南(2021年修订版)[J].中华结核和呼吸杂志,2021,44(3):170-205. [10] Feng J Y,Hu M H,Duan H F.Bidirectional association between tuberculosis and chronic obstructive pulmonary disease:a systematic review and meta-analysis[J/OL].J Clin Med,2025,14(21)[2026-09-23].https://doi.org/10.3390/jcm14217639. [11] 陆璐,施爱民,刘起展.细胞外囊泡在吸烟所致慢性阻塞性肺病中作用及其机制研究进展[J].中国公共卫生,2023,39(3):400-404. [12] Błach J,Siedliński M,Sydor W.Immunology in COPD and the use of combustible cigarettes and heated tobacco products[J/OL].Eur J Med Res,2023,28(1)[2026-09-23].https://doi.org/10.1186/s40001-023-01374-2. [13] Vashakidze S A,Chandrakumaran A,Japaridze M,et al.A case report of persistent drug-sensitive pulmonary tuberculosis after treatment completion[J/OL].BMC Infect Dis.2022,22(1)[2026-09-23].https://doi.org/10.1186/s12879-022-07836-y. [14] Zhang Y,Zhang Y P,Ma N L,et al.Correlation between elderly patients with COPD and the impact on immunity in tuberculosis patients:a retrospective study[J/OL].Medicine,2024,103(42)[2026-09-23].https://doi.org/10.1097/MD.0000000000040140. [15] 吴玉姣,左小明,秦科宇,等.常州市老年肺结核患者利福平耐药分析[J].预防医学,2024,36(2):162-164,168. [16] Starshinova A,Nazarenko M,Belyaeva E,et al.Assessment of comorbidity in patients with drug-resistant tuberculosis[J/OL].Pathogens,2023,12(12)[2026-09-23].https://doi.org/10.3390/pathogens12121394. [17] Thawanaphong S,Nair P.Contemporary concise review 2024:chronic obstructive pulmonary disease[J].Respirology,2025,30(7):574-586.