Qiu Minzhi, Lai Zhengdao, Wei Shushan, Jiang Qian, Xie Jiaxing, Qiu Rihuang, Wang Zhiqiang, Zhong Changhao, Chen Yu, Zhang Qingling, Li Shiyue, Zhong Nanshan
Department of Allergy and Clinical Immunology, Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
Department of Respiratory and Critical Care Medicine, Shenzhen Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Southern University of Science and Technology, The Second Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen 518020, China.
J Thorac Dis. 2018 Oct;10(10):E721-E726. doi: 10.21037/jtd.2018.09.116.
Bronchial thermoplasty (BT) is used in the treatment of severe refractory asthma. It has been found to be beneficial to long-term improvements in the rate of asthma exacerbation, quality of life questionnaire answers (AQLQ), hospitalization, and emergency room visits. Atelectasis and lung abscess as direct complication of BT, but not bronchiectasis, have been reported previously. In this study, we report bronchiectasis after BT in what we believe may be the first case, combined with optical coherence tomography (OCT) and a 3-year follow-up of chest computed tomography (CT), to evaluate a patient with severe persistent asthma. We describe a 49-year-old Chinese male who complained of recurrent wheezing lasting over 5 years. His chest CT scan was normal before BT, but one month thereafter, he presented with mild central bronchiectasis on high-resolution CT, which persisted for more than 4 years. It remains unclear why this patient developed bronchiectasis so early post-BT treatment. This case highlights the need for short-term and long-term safety data on BT.
支气管热成形术(BT)用于治疗严重难治性哮喘。已发现其有助于长期改善哮喘恶化率、生活质量问卷答案(AQLQ)、住院率及急诊就诊率。此前有报道称,肺不张和肺脓肿是BT的直接并发症,但支气管扩张不是。在本研究中,我们报告了可能为首例BT术后发生支气管扩张的病例,并结合光学相干断层扫描(OCT)及胸部计算机断层扫描(CT)的3年随访,对一名重度持续性哮喘患者进行评估。我们描述了一名49岁的中国男性,他主诉反复喘息超过5年。BT术前其胸部CT扫描正常,但术后1个月,高分辨率CT显示轻度中央型支气管扩张,这种情况持续了4年多。目前尚不清楚该患者为何在BT治疗后这么早发生支气管扩张。该病例凸显了获取BT短期和长期安全性数据的必要性。