Tesis

Proporsi gangguan faal paru dan kelainan morfologi HRCT toraks pasien bekas tuberkulosis resistan obat di RS Persahabatan = The proportion of lung function impairment and chest highresolution computed tomography (HRCT) features in former drugresistant tuberculosis patients at Persahabatan Hospital.

Latar belakang : Infeksi tuberkulosis resistan obat (TB RO) menyebabkan angka morbiditas yang tinggi, bahkan setelah pasien berhasil menuntaskan pengobatannya. Pasien bekas TB RO seringkali masih mengalami gejala respirasi akibat gangguan faal paru dan kerusakan struktur permanen yang terjadi di paru maupun ekstraparu. Namun demikian, belum banyak penelitian yang membahas terkait gangguan faal paru dan kelainan morfologi HRCT toraks yang dapat diakibatkan oleh infeksi TB RO. Metode : Penelitian menggunakan metode potong lintang pada 50 pasien bekas TB RO yang menyelesaikan pengobatan pada tahun 2020 hingga 2022 di RS persahabatan. Subjek penelitian akan menjalani pemeriksaan uji faal paru, Diffusing Capacity of the Lungs for Carbon Monoxide (DLCO) dan High Resolution Computed Tomography (HRCT) toraks. Hasil : Pada penelitian ini diperoleh median usia subjek adalah 37 (IQR 23). Jenis kelamin terbanyak adalah laki-laki yaitu 27 (54%) subjek. Sejumlah 33 (66%) subjek masih memiliki keluhan respirasi, diantaranya adalah sesak napas, mudah lelah dan batuk. Gangguan faal paru terbanyak adalah restriksi 18 (36%) subjek diikuti campuran restriksi obstruksi pada 13 (26%) subjek dan obstruksi pada 2 (4%) subjek. Penurunan kapasitas difusi paru terjadi pada 38 (76%) subjek, 19 (38%) subjek mengalami penurunan kapasitas difusi derajat ringan. Lesi terbanyak yang ditemukan pada subjek adalah fibrosis paru dan bronkiektasis. Lesi ditemukan paling banyak pada regio apeks dan superobasal. Derajat lesi HRCT toraks terbanyak yang ditemukan adalah derajat lesi ringan (50%). Seluruh subjek dengan derajat lesi HRCT toraks sedang-berat mengalami gangguan faal paru. Analisis multivariat menunjukkan hubungan bermakna antara derajat lesi dengan gangguan faal paru (nilai p = 0,005). Kesimpulan : Penelitian ini menunjukkan proporsi gangguan faal paru pada pasien bekas TB RO cukup tinggi. Terdapat hubungan bermakna antara gangguan faal paru dan derajat lesi pada HRCT toraks.
Kata kunci : Bekas TB RO, uji faal paru, spirometri, DLCO, HRCT toraks


Background: Drug-resistant tuberculosis (DR-TB) infection causes high morbidity rates, even after treatment has been completed. Former DR-TB patients often still experience respiratory symptoms due to lung function impairment and permanent structural damage that occurs in the lungs and extrapulmonary. However, only a few studies evaluate lung function disorders and the characteristics of chest HRCT lesions caused by DR-TB infection. Method: This is a cross-sectional study on 50 former DR-TB patients who had completed treatment in 2020 to 2022 at Persahabatan Hospital. The subjects underwent lung function tests, Diffusing Capacity of the Lungs for Carbon Monoxide (DLCO) and chest High- Resolution Computed Tomography (HRCT). Results: In this study, the median age of the subjects was 37 (IQR 23). Male population was 27 (54%) subjects. A total of 33 (66%) subjects still had respiratory complaints, including breathlessness, fatigue and cough. The most common lung function disorder was restriction in 18 (36%) subjects followed by mixed obstruction restriction in 13 (26%) subjects and obstruction in 2 (4%) subjects. Decreased lung diffusion capacity occurred in 38 (76%) subjects, 19 (38%) subjects experienced a mild decrease in diffusion capacity. The most common features found in subjects were pulmonary fibrosis and bronchiectasis. Lesions are found most often in the apex and supero-basal regions. The most common lesion on chest HRCT was mild degree (50%). All subjects with moderate to severe HRCT lesions experienced pulmonary function disorders. Multivariate analysis showed a significant relationship between the grading of chest HRCT lesion and lung function impairment (p = 0,005). Conclusion: This study shows the proportion of lung function impairment in former DR- TB patients is quite high. There is a significant relationship between lung function disorders that occur and the degree of lesion on chest HRCT.
Key words: Former TB RO, lung function test, spirometry, DLCO, chest HRCT