الفهرس 
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Abstract
The present study was conducted on 500 COPD patients presented to chest outpatient clinics of Menoufia University Hospital and Sherbin Chest hospital during the period from May 2018 to July 2019.
Patients were diagnosed COPD and included in the study according to spirometric results as recommended by GOLD guidelines.
A post bronchodilator FEV1/FVC < 0.70 confirms a diagnosis of airflow obstruction.
80 patient had past history of tuberculosis either pulmonary or extra-pulmonary history of Tuberculosis was evaluated from both groups through self-reporting and or checking previous records.
50 patients with TB-associated COPD were compared with other matched group of COPD without TB patients.
These 100 patients were subjected to full history taking, full clinical examination, pulmonary function testing and reversibility, chest x-ray, arterial blood gases.
from the present study, the following results were obtained:
(64%) subjects of TB-associated COPD group were nonsmokers, Suggesting that TB is significantly associated with COPD, Smoking did not alter or modify the association between TB and COPD as more than the half of PTB are non- smoker despite developing COPD (table 5).
50 (100%) subjects of TB-associated COPD group had cough, while 39 (78%) subjects of COPD patients without TB had cough (table 6).
(46%) of TB-associated COPD had dyspnea of grade 3according to m MRC dyspnea scale while (30%) of COPD without TB patients had dyspnea of grade 3 (table 7).
COPD patient with past history of tuberculosis had significant increase in the severity of his respiratory symptom and more exacerbations than COPD patient without tuberculous history.
(73.7%) subjects of TB-associated COPD group had diabetes, while (36.7%) subjects of COPD patients without TB had diabetes (table 8).
(64%) subjects of TB-associated COPD group had frequent exacerbations while (58%) subjects of COPD patients without TB had frequent exacerbations (table 9).
There is significant decrease in FEV1 value for past pulmonary tuberculosis patients than past extra-pulmonary patients and patients without TB (table 13).
There was a significant increase in the PaCO2 of TB-associated COPD group compared with COPD patients without TB (table 16).
There is significant decrease in pao2 value for past pulmonary tuberculosis patients than past extra-pulmonary patients and patients without TB (table15).
(44%)of TB-associated COPD had hyperinflation with fibrotic and bronchiectatic changes, while the other 56% did not have these changes suggesting that Post tuberculous radiological changes not necessary for air way obstruction or define its severity as the obstruction could happen even in minimal fibrotic or normal cases (table 18).
(64%) patients received two or more anti-TB courses (Table 19).
There was a significant increase in time elapsed since completion of TB treatment and start of COPD symptoms in patients treated with one anti-TB courses compared with those treated with two courses (Table22).
There was significant decrease in pulmonary functions in patients took two or more anti-tuberculous courses than that in patients who took only one course (table 23).