Fifth People's Hospital of Dongguan, Dongguan, Guangdong, China (mainland).
State Key Lab of Respiratory Disease, The Institute for Chemical Carcinogenesis, Collaborative Innovation Center for Environmental Toxicity, Guangzhou Medical University, Guangzhou, Guangdong, China (mainland).
Med Sci Monit. 2019 Sep 10;25:6805-6811. doi: 10.12659/MSM.917034.
BACKGROUND The prevalence of bronchiectasis with comorbid chronic obstructive pulmonary disease (COPD) is rising, which causes extremely high risk of exacerbation and mortality. We aimed to evaluate the differences in clinicopathological manifestations, immune function, and inflammation in bronchiectasis patients with comorbid COPD vs. patients who only have COPD. MATERIAL AND METHODS Clinicopathological characteristics, including common potentially pathogenic microorganisms, lung function, immune function, and inflammation were assessed in bronchiectasis patients with comorbid COPD and in patients who only had COPD. RESULTS Compared to patients who only had COPD, patients with bronchiectasis with comorbid COPD had a higher positive rate of sputum bacteria (45.27% vs. 28.03%, P<0.01). Among them, Pseudomonas aeruginosa (P. aeruginosa) accounted for 25.19% in COPD (4.37%) (P<0.01). Likewise, patients with bronchiectasis with comorbid COPD had worse lung function, worse COPD assessment test scores, and worse Modified Medical Research Council scores. Moreover, compared with COPD only cases, patients with bronchiectasis with comorbid COPD had higher levels of white blood cells (WBC), neutrophils, C-reactive protein (CRP), and procalcitonin (PCT) (all P<0.05). Interestingly, the expression levels of Treg in patients with bronchiectasis with comorbid COPD were lower than in patients with COPD only (P<0.05). Th17 and Th17/Treg levels were higher (P<0.05). Furthermore, remarkable increased level of IL17 and IL-6 and decreased level of IL-10 and TGF-ß were observed in the bronchiectasis combined COPD than in pure COPD (All P<0.05). CONCLUSIONS Our findings suggest that P. aeruginosa is the main pathogen of bacterial infection in bronchiectasis patients with comorbid COPD. These patients have more serious clinical manifestations and immune imbalance, which should be considered when providing clinical treatment.
合并慢性阻塞性肺疾病（COPD）的支气管扩张症患病率不断上升，导致加重和死亡的风险极高。本研究旨在评估合并 COPD 的支气管扩张症患者与仅患有 COPD 的患者之间在临床病理表现、免疫功能和炎症方面的差异。
评估合并 COPD 的支气管扩张症患者和仅患有 COPD 的患者的临床病理特征，包括常见潜在致病微生物、肺功能、免疫功能和炎症。
与仅患有 COPD 的患者相比，合并 COPD 的支气管扩张症患者的痰液细菌阳性率更高（45.27% vs. 28.03%，P<0.01）。其中，铜绿假单胞菌（P. aeruginosa）在 COPD 中占 25.19%（4.37%）（P<0.01）。同样，合并 COPD 的支气管扩张症患者的肺功能更差，COPD 评估测试评分和改良医学研究委员会评分更差。此外，与仅 COPD 病例相比，合并 COPD 的支气管扩张症患者的白细胞（WBC）、中性粒细胞、C 反应蛋白（CRP）和降钙素原（PCT）水平更高（均 P<0.05）。有趣的是，合并 COPD 的支气管扩张症患者的 Treg 表达水平低于仅 COPD 患者（P<0.05）。Th17 和 Th17/Treg 水平更高（P<0.05）。此外，与单纯 COPD 相比，合并 COPD 的支气管扩张症患者中观察到 IL17 和 IL-6 水平显著升高，IL-10 和 TGF-β水平降低（均 P<0.05）。
我们的研究结果表明，铜绿假单胞菌是合并 COPD 的支气管扩张症患者细菌感染的主要病原体。这些患者的临床表现更严重，免疫失衡更明显，在提供临床治疗时应考虑到这一点。
