Department of Respiratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK.
University of Edinburgh/MRC Centre for Inflammation Research, Queen's Medical Research Institute, Edinburgh, UK.
Chest. 2017 Feb;151(2):383-388. doi: 10.1016/j.chest.2016.09.022. Epub 2016 Oct 6.
Interest in the association of vascular disease with COPD and pneumonia has increased, but there is a lack of research in this area with patients with bronchiectasis.
A retrospective study of 400 patients attending a specialist bronchiectasis clinic in NHS Lothian (Edinburgh, UK) between May 2013 and September 2014 was conducted. The study assessed the prevalence of vascular disease (ischemic heart disease, cerebrovascular disease, peripheral vascular disease, and atrial fibrillation). Using multivariable models, independent risk factors were identified for vascular disease that developed following the diagnosis of bronchiectasis.
The study included 400 patients. There was preexisting vascular disease (ie, before the diagnosis of bronchiectasis) in 44 patients (11%), and vascular disease occurred after the diagnosis of bronchiectasis after a mean of 9.4 years (95% CI, 6.0-12.8 years) in 45 patients (11%). Independent factors associated with all-cause vascular disease after the diagnosis of bronchiectasis included male sex, hypertension, receiving long-term statin therapy, and having moderate-severity bronchiectasis or worse.
In conclusion, bronchiectasis severity is independently associated with the development of vascular disease after the diagnosis of bronchiectasis. Future studies addressing the impact of primary and secondary prevention are warranted.
人们对血管疾病与 COPD 和肺炎的关联越来越感兴趣,但在支气管扩张症患者中,这方面的研究还很缺乏。
对 2013 年 5 月至 2014 年 9 月期间在 NHS 洛锡安区(英国爱丁堡)的专科支气管扩张症诊所就诊的 400 名患者进行了回顾性研究。该研究评估了血管疾病(缺血性心脏病、脑血管疾病、外周血管疾病和心房颤动)的患病率。使用多变量模型,确定了在诊断支气管扩张症后发生血管疾病的独立危险因素。
该研究纳入了 400 名患者。44 名患者(11%)存在预先存在的血管疾病(即在诊断支气管扩张症之前),45 名患者(11%)在诊断支气管扩张症后平均 9.4 年(95%CI,6.0-12.8 年)发生血管疾病。与支气管扩张症诊断后全因血管疾病相关的独立因素包括男性、高血压、长期服用他汀类药物、中重度或更严重的支气管扩张症。
总之,支气管扩张症的严重程度与支气管扩张症诊断后血管疾病的发生独立相关。需要进一步研究一级和二级预防对血管疾病的影响。