ĐẶC ĐIỂM LÂM SÀNG VÀ DỊCH RỬA PHẾ QUẢN CỦA BỆNH NHÂN GIÃN PHẾ QUẢN SAU LAO PHỔI

Abstract

Background: Bronchiectasis is relatively common in the Asian population, especially post-tuberculosis bronchiectasis (PTBE). PTBE is associated with more severe disease progression and faster decline in lung function compared to bronchiectasis caused by other causes. In Vietnam, there is limited data on PTBE. The research question is whether PTBE in Vietnam has any specific characteristics and whether there are differences between PTBE and bronchiectasis caused by other causes. Objectives: This study aims to describe the clinical characteristics and bronchial lavage fluid findings of adult patients with PTBE in Vietnam; to compare the characteristics of PTBE patients with those of bronchiectasis patients due to other causes. Methods: A cross-sectional descriptive study of adult patients with stable bronchiectasis who underwent bronchoscopy at Cho Ray Hospital and the University Medical Center Ho Chi Minh City from May 2022 to January 2024. Results: Among 139 bronchiectasis patients, 46 cases (33.1%) met the diagnostic criteria for PTBE. The patients in our study had an average age of 60 ± 13, with female predominance (59%). Coughing and sputum production were the most common symptoms (71.9%). Pseudomonas aeruginosa was the most frequent bacteria isolated in both groups. Features of PTBE are more common in males (56.5%), a low BMI (20.3 ± 2.8 kg/m2), hemoptysis (41.7%) and signs of bronchiectasis on imaging predominantly in the upper lobes of the lungs (87%). There was no significant difference in disease severity (based on bronchiectasis severity index, FACED, and Reiff) between PTBE and bronchiectasis due to other causes. Conclusion: PTBE is a common cause of bronchiectasis in countries with high tuberculosis prevalence as Vietnam. It has quite distinctive clinical features, so classifying PTBE as a separate clinical phenotype of bronchiectasis could improve the quality of management and prognosis.