Flume Patrick A, Yankaskas James R, Ebeling Myla, Hulsey Thomas, Clark Leslie L
Department of Medicine, Medical University of South Carolina, 96 Jonathan Lucas St, 812-CSB, Charleston, SC 29425, USA.
Chest. 2005 Aug;128(2):729-38. doi: 10.1378/chest.128.2.729.
Massive hemoptysis is a complication commonly reported in patients with cystic fibrosis (CF). An understanding of the pathophysiology of this complication and its consequences is important for the management of patients with CF.
To identify risk factors associated with massive hemoptysis, and to determine the prognosis of patients following an episode of massive hemoptysis.
A retrospective, observational cohort study of the National CF Patient Registry between the years 1990 to 1999.
The Registry contained data on 28,858 patients with CF observed over 10 years at CF centers across the United States.
Massive hemoptysis occurred with an average annual incidence of 0.87% and in 4.1% of patients overall. There was no increased occurrence by sex, but it was more prevalent in older patients (mean age, 24.2 +/- 8.7 years [+/- SD]) with more severe pulmonary impairment (nearly 60% of patients who had an episode of massive hemoptysis had FEV1 < 40% predicted). The principal risks associated with an increased occurrence of massive hemoptysis included the presence of Staphylococcus aureus in sputum cultures (odds ratio [OR], 1.3) and diabetes (OR, 1.1). There was an increased morbidity (eg, increased hospitalizations and hospital days) and an increased 2-year mortality following massive hemoptysis.
Massive hemoptysis is a serious complication in CF patients, occurring more commonly in older patients with more advanced lung disease. Nearly 1 in 100 patients will have this complication each year. There is an attributable mortality to the complication and considerable morbidity, resulting in increased health-care utilization and a measurable decline in lung function.
大量咯血是囊性纤维化（CF）患者中常见的一种并发症。了解该并发症的病理生理学及其后果对于CF患者的管理至关重要。
确定与大量咯血相关的危险因素，并确定大量咯血发作后患者的预后。
对1990年至1999年期间国家CF患者登记处进行的一项回顾性观察队列研究。
该登记处包含了在美国各地CF中心对28858例CF患者进行10年观察的数据。
大量咯血的平均年发病率为0.87%，总体患者中的发生率为4.1%。发病率在性别上无增加，但在年龄较大（平均年龄24.2±8.7岁[±标准差]）、肺部损害更严重的患者中更常见（近60%发生大量咯血的患者FEV1<预测值的40%）。与大量咯血发生率增加相关的主要风险包括痰培养中存在金黄色葡萄球菌（比值比[OR]，1.3）和糖尿病（OR，1.1）。大量咯血后发病率增加（如住院次数和住院天数增加），2年死亡率增加。
大量咯血是CF患者的一种严重并发症，在肺部疾病更严重的老年患者中更常见。每年近1/100的患者会出现这种并发症。该并发症存在可归因的死亡率和相当高的发病率，导致医疗保健利用率增加和肺功能明显下降。
