Başaran Abdurrahman Erdem, Başaran Ayşen, Maslak İbrahim Cemal, Arslan Gökhan, Bingöl Ayşen
Division of Pediatric Pulmonology, Akdeniz University School of Medicine, Antalya, Turkey.
Department of Pediatrics, Akdeniz University School of Medicine, Antalya, Turkey.
Turk Thorac J. 2018 Sep 13;19(4):159-164. doi: 10.5152/TurkThoracJ.2018.17081. Print 2018 Oct.
The aim of this study was to evaluate radiological, clinical, and demographic data of patients with noncystic fibrosis bronchiectasis and to compare high-resolution computed tomography (HRCT) scores based on the demographic and clinical characteristics.
A total of 34 patients (18 male, 16 female) were assessed in terms of age at symptom onset, age at diagnosis, annual attack frequency, cough severity score, physical examination findings, and pulmonary function test results. Modified Bhalla scoring system (B total) and anatomical prevalence degree score (D total) were used for HRCT examination.
There was a strong negative correlation between forced expiratory volume at first second (FEV) and bronchial dilatation degree (SBRDIL). There was a moderate negative correlation of FEV, forced vital capacity (FVC), and maximum mid-expiratory flow rate (MEF; 25-75) with bronchiectasis degree (EXBRNC), bronchial wall thickness degree (SBWTHICK), and mucus accumulation in the major airways (PMPLA). The B total, D total, EXBRNC, and SBRDIL scores were significantly higher in patients with hemoptysis and sputum. In comparing B and D total scoring systems, B total provided better results in terms of rale, annual exacerbation frequency (AEF), cough severity score (CSS), and FEV values.
As it is proved using HRCT, pulmonary function impairment, sputum production, hemoptysis, and increase in AEF strongly correlating with objective HRCT scoring can be accepted as markers for pathological changes due to bronchiectasis.
本研究旨在评估非囊性纤维化支气管扩张症患者的放射学、临床和人口统计学数据,并根据人口统计学和临床特征比较高分辨率计算机断层扫描(HRCT)评分。
共评估了34例患者(18例男性,16例女性),记录症状出现年龄、诊断年龄、年发作频率、咳嗽严重程度评分、体格检查结果和肺功能测试结果。HRCT检查采用改良的巴拉评分系统(B总分)和解剖学患病率评分(D总分)。
第1秒用力呼气量(FEV)与支气管扩张程度(SBRDIL)之间存在强负相关。FEV、用力肺活量(FVC)和最大呼气中期流速(MEF;25 - 75)与支气管扩张程度(EXBRNC)、支气管壁厚度(SBWTHICK)和主气道黏液积聚(PMPLA)之间存在中度负相关。咯血和咳痰患者的B总分、D总分、EXBRNC和SBRDIL评分显著更高。在比较B总分和D总分评分系统时,B总分在啰音、年加重频率(AEF)、咳嗽严重程度评分(CSS)和FEV值方面提供了更好的结果。
正如HRCT所证实的,肺功能损害、咳痰、咯血以及与客观HRCT评分密切相关的AEF增加可被视为支气管扩张所致病理变化的标志物。