OBJECTIVE To explore the clinical characteristics of the nontuberculous Mycobacteria pulmonary disease (NTMPD) patients with previous pulmonary tuberculosis (PPTB) and analyze the clinical difference from the recurrence of pulmonary tuberculosis.

METHODS By means of retrospective survey, the patients who were diagnosed with NTMPD and recurrent pulmonary tuberculosis in Wuhan Pulmonary Hospital from Mar. 2021 to Oct. 2023 were recruited as the research subjects, a total of 395 patients with NTMPD were enrolled in the study and were divided into the PPTB-NTMPD group with 92 cases and the NPPTB-NTMPD group with 303 cases according to the history of PPTB. The baseline data, clinical symptoms, imaging findings, underlying diseases, pulmonary diseases, and species of nontuberculous Mycobacteria (NTM) were observed and compared. Totally 92 patients with recurrent pulmonary tuberculosis were randomly screened and assigned as the recurrent pulmonary tuberculosis group in a 1∶1 ratio by matching the PPTB-NTMPD group with the gender and age. The major clinical characteristics were compared between the two groups. The 92 patients with PPTB-NTMPD were divided into the 1-10 years group with 40 cases, the 10-30 years group with 37 cases, and the more than 30 years group with 15 cases according to the interval between the initial diagnosis of pulmonary tuberculosis and the diagnosis of NTMPD. The major clinical characteristics were compared among the groups.

RESULTS The age was (64.21±10.71) years old in the PPTB-NTMPD group, (60.26±11.83) years old in the NPPTB-NTMPD group (t=3.020, P=0.003). The proportion of patients with body mass index less than 18.5 kg/m² was 59.78% in the PPTB-NTMPD group, 41.25% in the NPPTB-NTMPD group (χ²=6.155, P=0.013); the proportion of patients with cough was 77.17% in the PPTB-NTMPD group, 65.68% in the NPPTB-NTMPD group (χ²=4.313, P=0.038); the incidence of cavitary shadow was 50.00% in the PPTB-NTMPD group, 35.31% in the NPPTB-NTMPD group (χ²=6.414, P=0.011); the incidence of emphysema and pulmonary bullae was 29.35% in the PPTB-NTMPD group, 12.87% in the NPPTB-NTMPD group (χ²=13.766, P<0.001); the incidence of chronic obstructive pulmonary disease (COPD) was 22.83% in the PPTB-NTMPD group, 14.19% in the NPPTB-NTMPD group (χ²=3.875, P=0.049); the incidence of damaged lung was 9.78% in the PPTB-NTMPD group, 2.97% in the NPPTB-NTMPD group (χ²=7.530, P=0.014); there were significant differences. Mycobacterium intracellulare and Mycobacterium abscessus were the predominant species of NTM in both the PPTB-NTMPD group and the NPPTB-NTMPD group, there was no significant difference in the distribution of NTM species between the two groups of patients. The incidence of patch shadow of the PPTB-NTMPD group was lower than that of the recurrent pulmonary tuberculosis group(P<0.05), the incidence of bronchiectatic shadow of the PPTB-NTMPD group was higher than that of the recurrent pulmonary tuberculosis group(P<0.05). There were significant differences in the age, incidence of pleural thickening and incidence of COPD among the patients with different time intervals between initial diagnosis of pulmonary tuberculosis and the diagnosis of NTMPD in the PPTB-NTMPD group(P<0.05).

CONCLUSIONS The previous pulmonary tuberculosis mainly affect the body mass index less than 18.5 kg/m² and the post-tuberculosis pulmonary diseases such as cough, pulmonary cavity, emphysema, pulmonary bullae, COPD and damaged lung of the NTMPD patients. The NTMPD patients with previous pulmonary tuberculosis are more likely to have bronchiectasia than the patients with recurrent tuberculosis. It is necessary for the clinicians to attach great importance.