Clinical characteristics and immune function of chronic obstructive pulmonary disease complicated with pulmonary tuberculosis in western Guangxi

Objective: To understand the characteristics, immune function and pulmonary function of tuberculosis-associated chronic obstructive pulmonary disease (T-COPD) in western Guangxi, and to improve the diagnosis and treatment of these diseases.Methods: 150 patients with T-COPD in the respiratory medicine department of Baise People's Hospital from July 2019 to July 2020 were selected as the T-COPD group, and 150 patients with smoking-associated COPD (S-COPD) were selected as the S-COPD group.The clinical symptoms, imaging characteristics, pulmonary function and immune function of the patients in both groups were compared.Patients in the T-COPD group were divided into group A(n=67, conventional treatment)and group B(n=83, conventional treatment combined with anti-tuberculosis treatment) according to their willingness to be treated.The pulmonary function, disappearance rate of bilateral lung shadows, improvement rate of cavitation, sputum bacteria conversion rate and immune function were compared between the two groups.And 2-year follow-up was performed to assess the severity of the disease using the chronic obstructive pulmonary disease assessment test score (CAT)and the cumulative acute exacerbation rate.Results: The incidence of chest pain and night sweats in the T-COPD group was higher than that in the S-COPD group.The incidence of imaging features of mass, “lobar” sign, burrlike nodule, pleural sag, cavity and striated shadow in the T-COPD group was higher than that in the SCOPD group (all P＜0.05).Patients in the T-COPD group had lower forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC), ratio of FEV1 to FVC(FEV₁/FVC), CD4⁺ and CD8⁺, and higher IgA and IgG levels than patients in the S-COPD group (all P＜0.05).FVC, CD4+, CD8+, disappearance rate of bilateral lung shadows, improvement rate of cavitation and sputum bacteria conversion rate in group B were higher than those in group A; IgA, IgG, CAT scores and cumulative acute exacerbation rate were lower than those in group A(all P＜0.05).Conclusion: T-COPD patients experience more pronounced chest pain and night sweats, and have impaired pulmonary function and immune function.It is suggested to establish a comprehensive clinical analysis and give anti-tuberculosis treatment in time to promote the recovery of pulmonary function and improve the immune level.