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慢性阻塞性肺疾病中支气管扩张的特征及相关因素

Characteristics and related factors of bronchiectasis in chronic obstructive pulmonary disease.

作者信息

Yu Qihong, Peng Haiying, Li Bo, Qian Hongyu, Zhang Hong

机构信息

Respiratory and Critical Care Department.

Radiology Department, Tianjin Chest Hospital, Tianjin, China.

出版信息

Medicine (Baltimore). 2019 Nov;98(47):e17893. doi: 10.1097/MD.0000000000017893.

Abstract

The purpose of this study was to understand the incidence, clinical characteristics and related factors of bronchiectasis in chronic obstructive pulmonary disease (COPD) patients.From January 2015 to January 2017, 133 patients with moderate to severe COPD admitted to our hospital were enrolled in the study. Bronchiectasis analysis was performed by high resolution CT of the chest, the clinical data of all patients were collected including increasing state of COPD, peripheral blood samples, pulmonary function, blood gas. And sputum samples were collected for detection of microorganisms.the patients were aged 70.18 ± 8.31 years, and 62.4% of the patients were male. FEV1 accounted for an estimated value of 37.91 ± 10.68%, and 104 (78.2%) were severe COPD, and 43 (32.3%) had bronchiectasis. Bronchiectasis is mainly bilateral, multiple and columnar bronchiectasis. The most easily involved sites are the left lower lobe, left lingual lobe and right middle lobe. Bronchiectasis is associated with history of disease (P = .027), at least one hospitalization exacerbated by COPD in the past year (P = .025), and the separation of potential pathogenic microorganisms from sputum (P = .022). The most commonly isolated pathogen was Pseudomonas aeruginosa (P < .001).Bronchiectasis should be noted in patients with COPD who often suffer from exacerbation or repeated respiratory infections, especially in those who isolate P aeruginosa from respiratory specimens.

摘要

本研究的目的是了解慢性阻塞性肺疾病(COPD)患者支气管扩张的发病率、临床特征及相关因素。2015年1月至2017年1月,我院收治的133例中重度COPD患者纳入本研究。通过胸部高分辨率CT进行支气管扩张分析,收集所有患者的临床资料,包括COPD加重状态、外周血样本、肺功能、血气。并收集痰样本检测微生物。患者年龄为70.18±8.31岁,62.4%为男性。FEV1占预计值的37.91±10.68%,104例(78.2%)为重度COPD,43例(32.3%)有支气管扩张。支气管扩张主要为双侧、多发和柱状支气管扩张。最易累及的部位是左下叶、左舌叶和右中叶。支气管扩张与疾病史(P = 0.027)、过去一年中至少一次因COPD加重住院(P = 0.025)以及痰中分离出潜在致病微生物(P = 0.022)有关。最常见分离出的病原体是铜绿假单胞菌(P < 0.001)。对于经常发生病情加重或反复呼吸道感染的COPD患者,尤其是那些从呼吸道标本中分离出铜绿假单胞菌的患者,应注意支气管扩张。

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本文引用的文献

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Self-management for bronchiectasis.支气管扩张症的自我管理
Cochrane Database Syst Rev. 2018 Feb 7;2(2):CD012528. doi: 10.1002/14651858.CD012528.pub2.
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Bronchiectasis in COPD patients: more than a comorbidity?慢性阻塞性肺疾病患者的支气管扩张:仅是一种合并症吗?
Int J Chron Obstruct Pulmon Dis. 2017 May 11;12:1401-1411. doi: 10.2147/COPD.S132961. eCollection 2017.

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