Pneumology Unit, Requena General Hospital; CIBER de enfermedades respiratorias, Valencia, Spain.
Pneumology Unit, Requena General Hospital.
Chest. 2011 Nov;140(5):1130-1137. doi: 10.1378/chest.10-1758. Epub 2011 May 5.
Previous studies have shown a high prevalence of bronchiectasis in patients with moderate to severe COPD. However, the factors associated with bronchiectasis remain unknown in these patients. The objective of this study is to identify the factors associated with bronchiectasis in patients with moderate to severe COPD.
Consecutive patients with moderate (50% < FEV(1) ≤ 70%) or severe (FEV(1) ≤ 50%) COPD were included prospectively. All subjects filled out a clinical questionnaire, including information about exacerbations. Peripheral blood samples were obtained, and lung function tests were performed in all patients. Sputum samples were provided for monthly microbiologic analysis for 6 months. All the tests were performed in a stable phase for at least 6 weeks. High-resolution CT scans of the chest were used to diagnose bronchiectasis.
Ninety-two patients, 51 with severe COPD, were included. Bronchiectasis was present in 53 patients (57.6%). The variables independently associated with the presence of bronchiectasis were severe airflow obstruction (OR, 3.87; 95% CI, 1.38-10.5; P = .001), isolation of a potentially pathogenic microorganism (PPM) (OR, 3.59; 95% CI, 1.3-9.9; P = .014), and at least one hospital admission due to COPD exacerbations in the previous year (OR, 3.07; 95% CI, 1.07-8.77; P = .037).
We found an elevated prevalence of bronchiectasis in patients with moderate to severe COPD, and this was associated with severe airflow obstruction, isolation of a PPM from sputum, and at least one hospital admission for exacerbations in the previous year.
先前的研究表明，中重度 COPD 患者中支气管扩张症的患病率较高。然而，这些患者中与支气管扩张症相关的因素尚不清楚。本研究旨在确定中重度 COPD 患者中与支气管扩张症相关的因素。
连续纳入中重度（50%<FEV1≤70%）或重度（FEV1≤50%）COPD 患者。所有患者均填写临床问卷，包括急性加重信息。所有患者均进行外周血样本采集和肺功能检查，并在稳定期至少 6 周后进行 6 个月的每月微生物分析。胸部高分辨率 CT 扫描用于诊断支气管扩张症。
共纳入 92 例患者，其中 51 例为重度 COPD。53 例（57.6%）患者存在支气管扩张症。与支气管扩张症存在独立相关的变量包括严重气流阻塞（OR，3.87；95%CI，1.38-10.5；P=0.001）、潜在致病微生物（PPM）的分离（OR，3.59；95%CI，1.3-9.9；P=0.014）和前一年因 COPD 急性加重至少住院一次（OR，3.07；95%CI，1.07-8.77；P=0.037）。
我们发现中重度 COPD 患者支气管扩张症的患病率较高，且与严重气流阻塞、痰中分离出 PPM 和前一年因急性加重至少住院一次有关。
