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慢性阻塞性肺疾病合并支气管扩张患者的病情加重

Exacerbations in COPD Patients with Bronchiectasis.

作者信息

Minov Jordan, Stoleski Saso, Mijakoski Dragan, Vasilevska Kristin, Atanasovska Aneta

机构信息

Institute for Occupational Health of R. Macedonia-WHO Collaborating Center, 1000 Skopje, Macedonia.

Institute for Epidemiology and Biostatistics, 1000 Skopje, Macedonia.

出版信息

Med Sci (Basel). 2017 Apr 11;5(2):7. doi: 10.3390/medsci5020007.

Abstract

There is evidence that coexisting bronchiectasis (BE) in patients with chronic obstructive pulmonary disease (COPD) aggravates the course of the disease. In this study, we aimed to evaluate the frequency and severity of bacterial exacerbations in COPD patients with BE. The frequency and duration of bacterial exacerbations treated in a 12-month period, as well as the duration of the exacerbation-free interval, were evaluated in 54 patients with COPD (Group D) who were diagnosed and assessed according to official recommendations. In 27 patients, BE was diagnosed by high-resolution computed tomography (HRCT), whereas an equal number of COPD patients who were confirmed negative for BE by HRCT, served as controls. We found a significantly higher mean number of exacerbations in a 12-month period in COPD patients with BE (2.9 ± 0.5), as compared to their mean number in controls (2.5 ± 0.3) (p = 0.0008). The mean duration of exacerbation, i.e. the mean number of days elapsed before complete resolution of the symptoms or their return to the baseline severity, was significantly longer in COPD patients with BE as compared to their mean duration in controls (6.9 ± 1.8 vs. 5.7 ± 1.4; p = 0.0085). In addition, the mean exacerbation-free interval expressed in days, in patients with COPD with BE, was significantly shorter than in COPD patients in whom BE were excluded (56.4 ± 17.1 vs. 67.2 ± 14.3; p = 0.0149). Overall, our findings indicate that coexisting BE in COPD patients may lead to more frequent exacerbations with a longer duration.

摘要

有证据表明,慢性阻塞性肺疾病(COPD)患者并存支气管扩张(BE)会加重疾病进程。在本研究中,我们旨在评估COPD合并BE患者细菌感染急性加重的频率和严重程度。根据官方建议,对54例COPD患者(D组)进行诊断和评估,记录其在12个月内接受治疗的细菌感染急性加重的频率和持续时间,以及无急性加重期的持续时间。27例患者通过高分辨率计算机断层扫描(HRCT)诊断为BE,而同样数量的经HRCT证实BE阴性的COPD患者作为对照。我们发现,COPD合并BE患者在12个月内的平均急性加重次数(2.9±0.5)显著高于对照组(2.5±0.3)(p = 0.0008)。COPD合并BE患者急性加重的平均持续时间,即症状完全缓解或恢复至基线严重程度之前经过的平均天数,显著长于对照组(6.9±1.8天 vs. 5.7±1.4天;p = 0.0085)。此外,COPD合并BE患者以天数表示的平均无急性加重期显著短于排除BE的COPD患者(56.4±17.1天 vs. 67.2±14.3天;p = 0.0149)。总体而言,我们的研究结果表明,COPD患者并存BE可能导致更频繁、持续时间更长的急性加重。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4479/5635786/3ec95de32f17/medsci-05-00007-g001.jpg

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