Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Department of respiratory internal medicine, Suzhou Science and Technology Town Hospital, Suzhou, China.
BMJ Open. 2018 Mar 14;8(3):e014613. doi: 10.1136/bmjopen-2016-014613.
occupies an important niche in the pathogenic microbiome of bronchiectasis. The objective of this study is to evaluate the clinical characteristics and prognostic value of in Chinese adult patients with bronchiectasis.
This retrospective and follow-up study enrolled 1188 patients diagnosed with bronchiectasis at Shanghai Pulmonary Hospital between January 2011 and December 2012. The patients' clinical data including anthropometry, clinical symptoms, serum biomarkers, radiographic manifestations and lung function indices were reviewed. The median follow-up duration (IQR) was 44 (40-54) months, during which 289 patients were lost to follow-up. Data from 899 patients were collected and analysed for the outcomes of mortality, annual exacerbation frequency and health-related quality of life.
was isolated from 232 patients, alongside other pathogens such as (n=75) and (n=72). There were 74 deaths (12% of patients with , 7.3% of those without) over the course of the follow-up. The isolation of was a risk factor for all-cause mortality (HR, 3.07; 95% CI 1.32 to 7.15) and was associated with high rates of exacerbations (ie, ≥3 exacerbations per year of follow-up) (HR, 2.40; 95% CI 1.20 to 4.79). Patients with also had worse scores on the Hospital Anxiety and Depression Scale (anxiety, p=0.005; depression, p<0.001), the Leicester Cough Questionnaire (p=0.033) and the modified Medical Research Council scale (p=0.001) compared with those without .
Isolation of in patients with bronchiectasis is a significant prognostic indicator and should be a major factor in the clinical management of the disease.
在支气管扩张症的致病微生物组中占据重要位置。本研究旨在评估 在中国成人支气管扩张症患者中的临床特征和预后价值。
本回顾性随访研究纳入了 2011 年 1 月至 2012 年 12 月在上海肺科医院诊断为支气管扩张症的 1188 例患者。回顾了患者的临床数据，包括人体测量学、临床症状、血清生物标志物、影像学表现和肺功能指标。中位随访时间（IQR）为 44（40-54）个月，期间有 289 例患者失访。共收集并分析了 899 例患者的死亡率、年加重频率和健康相关生活质量的结局数据。
从 232 例患者中分离出 ，同时还分离出其他病原体，如 （n=75）和 （n=72）。在随访过程中共有 74 例死亡（ 患者的 12%，无 患者的 7.3%）。 分离是全因死亡率的危险因素（HR，3.07；95%CI 1.32 至 7.15），与较高的加重率（即每年随访≥3 次加重）相关（HR，2.40；95%CI 1.20 至 4.79）。与无 患者相比， 患者的医院焦虑和抑郁量表（焦虑，p=0.005；抑郁，p<0.001）、莱斯特咳嗽问卷（p=0.033）和改良医学研究理事会量表（p=0.001）评分也更差。
支气管扩张症患者中 分离是一个重要的预后指标，应成为疾病临床管理的主要因素。
