State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Respirology. 2015 Jul;20(5):739-48. doi: 10.1111/resp.12528. Epub 2015 Mar 26.
Aetiologies of bronchiectasis in mainland China and their comparisons with those in western countries are unknown. We aimed to investigate bronchiectasis aetiologies in Guangzhou, southern China, and to determine ethnic or geographic differences with reports from western countries.
Consecutive patients with steady-state bronchiectasis were randomly recruited. Past history was meticulously extracted. Patients underwent physical examination, saccharine test, humoral immunity assays, gastroesophageal reflux scoring and sputum culture. Fiberoptic bronchoscopy, total immunoglobin E (IgE) and Aspergillus fumigatus-specific IgE measurement, 24-h gastroesophageal pH monitoring and miscellaneous screening tests were performed, if indicated. This entailed comparisons on aetiologies with literature reports.
We enrolled 148 patients (44.6 ± 13.8 years, 92 females), most of whom had mild to moderate bronchiectasis. Idiopathic (46.0%), post-infectious (27.0%) and immunodeficiency (8.8%) were the most common aetiologies. Miscellaneous aetiologies consisted of asthma (5.4%), gastroesophageal reflux (4.1%), aspergillosis (2.7%), congenital lung malformation (2.0%), Kartagener syndrome (1.4%), rheumatoid arthritis (1.4%), chronic obstructive pulmonary disease (0.7%), Young's syndrome (0.7%), yellow nail's syndrome (0.7%), eosinophilic bronchiolitis (0.7%) and foreign bodies (0.7%). No notable differences in clinical characteristics between idiopathic and known aetiologies were found. Ethnic or geographic variations of aetiologies were overall unremarkable.
Idiopathic, post-infectious and immunodeficiency constitute major bronchiectasis aetiologies in Guangzhou. Clinical characteristics of patients between known aetiologies and idiopathic bronchiectasis were similar. Ethnicity and geography only account for limited differences in aetiologic spectra. These findings will offer rationales for early diagnosis and management of bronchiectasis in future studies and clinical practice in China.
中国大陆支气管扩张症的病因及其与西方国家的比较尚不清楚。我们旨在研究中国南方广州的支气管扩张症病因，并确定与西方国家报告的种族或地理差异。
连续招募稳定期支气管扩张症患者。详细提取既往病史。对患者进行体格检查、味觉试验、体液免疫检测、胃食管反流评分和痰培养。如果需要，进行纤维支气管镜检查、总免疫球蛋白 E（IgE）和烟曲霉特异性 IgE 测定、24 小时胃食管 pH 监测和各种筛查试验。这需要与文献报告的病因进行比较。
我们共纳入 148 例患者（44.6±13.8 岁，92 例女性），其中大多数为轻度至中度支气管扩张症。特发性（46.0%）、感染后（27.0%）和免疫缺陷（8.8%）是最常见的病因。其他病因包括哮喘（5.4%）、胃食管反流（4.1%）、曲霉病（2.7%）、先天性肺畸形（2.0%）、Kartagener 综合征（1.4%）、类风湿关节炎（1.4%）、慢性阻塞性肺疾病（0.7%）、Young 综合征（0.7%）、黄甲综合征（0.7%）、嗜酸性细支气管炎（0.7%）和异物（0.7%）。特发性和已知病因患者的临床特征无明显差异。病因的种族或地理差异总体上无明显差异。
特发性、感染后和免疫缺陷是广州支气管扩张症的主要病因。已知病因和特发性支气管扩张症患者的临床特征相似。种族和地理因素仅占病因谱差异的有限部分。这些发现将为未来研究和中国临床实践中支气管扩张症的早期诊断和管理提供依据。
