Zhang Rong-Bao, Yuan Fei, Tan Xing-Yu, He Quan-Ying
Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, 11 Xizhimen South Street, Xicheng District, Beijing 100044, China.
Chronic Dis Transl Med. 2017 Apr 20;3(3):176-180. doi: 10.1016/j.cdtm.2017.02.007. eCollection 2017 Sep.
To investigate the presence of previously undiagnosed radiographic bronchiectasis in stable chronic obstructive pulmonary disease (COPD) patients using high resolution computed tomography (HRCT) and to evaluate the effect of radiographic bronchiectasis on the symptoms and risks in stable COPD patients.
From May 2012 to April 2014, there were 347 patients enrolled in COPD database. Data describing the general conditions, the frequency of acute exacerbations the year before, COPD assessment test, modified medical research council (mMRC) score, spirometric classification, and HRCT were collected. COPD patients were classified into two groups: COPD with bronchiectasis and COPD without bronchiectasis. The clinical characteristics of both groups were compared.
Bronchiectasis was presented in 18.4% ( = 64). The proportion of smokers, smoking index, and forced expiratory volume in 1 second predicted value were 62.5%, 27.3 ± 13.2, 48.2 ± 26.4, respectively, in the bronchiectasis group, which were lower than those of the group without bronchiectasis (82.0%, 32.6 ± 17.6, and 57.9 ± 18.8) ( < 0.05). Complications, COPD assessment test (CAT) and the rate of CAT ≥ 10 in the bronchiectasis group were 2.8 ± 1.7,13.6 ± 7.4 and 26.6%, respectively, which were higher than those of the group without bronchiectasis (2.3 ± 1.5,11.3 ± 6.0, and 11.7%) ( < 0.05). The proportion of type D (high-risk more-symptoms) in the bronchiectasis group was 50.0%; it was significantly higher than that of 35.7% in the group without bronchiectasis ( < 0.05).
COPD with bronchiectasis is associated with more complications, symptoms, and risks. More attention should be paid to the treatment of COPD with bronchiectasis to reduce the frequency of exacerbation and improve the health status.
使用高分辨率计算机断层扫描(HRCT)研究稳定期慢性阻塞性肺疾病(COPD)患者中先前未诊断出的影像学支气管扩张的存在情况,并评估影像学支气管扩张对稳定期COPD患者症状和风险的影响。
2012年5月至2014年4月,347例患者纳入COPD数据库。收集了描述一般情况、前一年急性加重频率、COPD评估测试、改良医学研究委员会(mMRC)评分、肺量计分类和HRCT的数据。COPD患者分为两组:合并支气管扩张的COPD组和不合并支气管扩张的COPD组。比较两组的临床特征。
支气管扩张的发生率为18.4%(n = 64)。支气管扩张组中吸烟者比例、吸烟指数和第1秒用力呼气容积预测值分别为62.5%、27.3±13.2、48.2±26.4,低于无支气管扩张组(82.0%、32.6±17.6和57.9±18.8)(P<0.05)。支气管扩张组的并发症、COPD评估测试(CAT)及CAT≥10的比例分别为2.8±1.7、13.6±7.4和26.6%,高于无支气管扩张组(2.3±1.5、11.3±6.0和11.7%)(P<0.05)。支气管扩张组中D型(高风险多症状)的比例为50.0%;显著高于无支气管扩张组的35.7%(P<0.05)。
合并支气管扩张的COPD与更多并发症、症状和风险相关。应更加关注合并支气管扩张的COPD的治疗,以降低加重频率并改善健康状况。