Li Zhu, Li Jiu-rong, Gao Jin-ming
Department of Respiratory Medicine, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2014 Feb;36(1):61-7. doi: 10.3881/j.issn.1000-503X.2014.01.012.
To summarize the clinical features of bronchiectasis.
We retrospectively analyzed the clinical data of 136 patients who had been admitted to Peking Union Medical College Hospital from January 2010 to December 2012 due to bronchiectasis, which was confirmed by high-resolution computed tomography.
The average age of these 136 patients (61 men and 75 women) was (57.7±16.3) years. The average clinical history was (17.2±15.8) years. The exact etiology was unidentified in 77.2% (105/136) of the patients. The most commonly identified cause was previous infections (14.7%, 20/136), particularly tuberculosis. The main symptoms of bronchiectasis were cough and sputum production. The types of bronchiectasis were cylindrical in 37.7% (37/98), varicose in 40.8% (40/98), cystic in 21.4% (21/98) of these patients. Multilober involvement was most common (77.2%, 105/136). The most commonly involved lobes were left lower lobe (76.5%, 104/136). Of 77 patients who had undergone pulmonary function test, 47 (61.0%) showed obstructive. For each bronchiectasis type, the values (percentages of predicted) of forced expiratory volume in one second (FEV1) (P=0.918), forced vital capacity (FVC) (P=0.982), and FEV1/FVC (P=0.211) showed no statistical significance. The most commonly identified pathogen in sputum culture was Pseudomonas aeruginosa, which was sensitive to most broad-spectrum antibiotics. Current infections were most common in patients with cystic bronchiectasis, among whom rales were frequently heard.
Most bronchiectasis patients are old women. The main etiology is previous infection, especially tuberculosis. The main symptom of bronchiectasis is productive cough. Many patients can have obstructive pulmonary function. The distribution of lesions is diffuse, and the lesions are often seen in both lungs, particularly in the left lower lobe. Cystic bronchiectasis may be a more severe type, and should be carefully managed once identified by radiology.
总结支气管扩张症的临床特征。
回顾性分析2010年1月至2012年12月因支气管扩张症入住北京协和医院的136例患者的临床资料,这些患者均经高分辨率计算机断层扫描确诊。
这136例患者(61例男性,75例女性)的平均年龄为(57.7±16.3)岁。平均临床病史为(17.2±15.8)年。77.2%(105/136)的患者确切病因不明。最常见的病因是既往感染(14.7%,20/136),尤其是肺结核。支气管扩张症的主要症状是咳嗽和咳痰。这些患者中,柱状支气管扩张占37.7%(37/98),静脉曲张型支气管扩张占40.8%(40/98),囊状支气管扩张占21.4%(21/98)。多叶受累最为常见(77.2%,105/136)。最常受累的肺叶是左下叶(76.5%,104/136)。77例进行了肺功能检查的患者中,47例(61.0%)表现为阻塞性通气功能障碍。对于每种支气管扩张类型,一秒用力呼气容积(FEV1)(预测值百分比)(P = 0.918)、用力肺活量(FVC)(P = 0.982)和FEV1/FVC(P = 0.211)的值均无统计学意义。痰培养中最常见的病原体是铜绿假单胞菌,对大多数广谱抗生素敏感。当前感染在囊状支气管扩张患者中最为常见,其中常可闻及湿啰音。
大多数支气管扩张症患者为老年女性。主要病因是既往感染,尤其是肺结核。支气管扩张症的主要症状是咳痰性咳嗽。许多患者可出现阻塞性肺功能。病变分布弥漫,常累及双肺,尤其是左下叶。囊状支气管扩张可能是一种更严重的类型,一旦经影像学确诊应予以仔细处理。