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[突尼斯某中心慢性阻塞性肺疾病患者的支气管扩张:对疾病进展和预后的影响]

[Bronchial dilatations in patients with chronic obstructive pulmonary disease in a Tunisian center: effect on disease progression and prognosis].

作者信息

Saad Ahmed Ben, Migaou Asma, Mhamed Saousen Cheikh, Fahem Nesrine, Rouatbi Naceur, Joobeur Samah

机构信息

Service de Pneumologie et d´Allergologie, Hôpital Universitaire Fattouma Bourguiba, Rue 1er juin, 5000 Monastir, Monastir, Tunisie.

出版信息

Pan Afr Med J. 2020 Oct 29;37:200. doi: 10.11604/pamj.2020.37.200.24448. eCollection 2020.

Abstract

INTRODUCTION

bronchial dilations (BDs) seem to have a major role in the natural history of chronic obstructive pulmonary disease (COPD). The purpose of our study was to evaluate the impact of BDs on the severity and progression of COPD as well as on patients' prognosis.

METHODS

we conducted a retrospective, single-center, analytical study over the period 1995- 2017. The study was based on data from the medical records of patients with COPD who had undergone chest CT scan during the follow-up period. We compared two groups (G) of patients: G1: COPD with BDs; G2: COPD without BDs.

RESULTS

our study included 466 patients with COPD. Among them 101 (21.6%) had BDs associated with COPD. G1 patients had lower maximum expiratory volume in the first second (FEV1) (G1: 1.21 L, G2: 1.37 L, p = 0.015), lower forced vital capacity (FVC) (p = 0.014), a lower PaO2 at steady state (p = 0.049), a higher rate of acute exacerbations (AE) per year (G1: 3.31, G2: 2.44, p = 0.001) and a higher rate of hospitalizations in the Intensive Care Unit per year (p = 0.02). G1 patients with AE receiving treatment in hospital had lower PaO2 3) on admission (G1: 60 mmHg, G2: 63.7 mmHg, p = 0.02 G2: 63.7 mmHg, p = 0.023), more elevated carbon dioxide (CO2) levels (p = 0.001) and were characterized by a higher use of non-invasive ventilation (NIV) (p = 0.044) and invasive mechanical ventilation (p = 0.011). G2 patients had better overall survival (p = 0.002).

CONCLUSION

bronchial dilatations are an indicator of poor prognosis in patients with chronic obstructive pulmonary disease, expecially because of the higher rate and severity of exacerbations, airway obstructions and mortality.

摘要

引言

支气管扩张(BDs)似乎在慢性阻塞性肺疾病(COPD)的自然病程中起主要作用。我们研究的目的是评估BDs对COPD严重程度和进展以及患者预后的影响。

方法

我们在1995年至2017年期间进行了一项回顾性、单中心分析研究。该研究基于随访期间接受胸部CT扫描的COPD患者的病历数据。我们比较了两组患者:G1组:伴有BDs的COPD患者;G2组:不伴有BDs的COPD患者。

结果

我们的研究纳入了466例COPD患者。其中101例(21.6%)患有与COPD相关的BDs。G1组患者第一秒最大呼气量(FEV1)较低(G1组:1.21L,G2组:1.37L,p = 0.015),用力肺活量(FVC)较低(p = 0.014),稳态下PaO2较低(p = 0.049),每年急性加重(AE)发生率较高(G1组:3.31,G2组:2.44,p = 0.001),每年入住重症监护病房的发生率较高(p = 0.02)。因AE住院接受治疗的G1组患者入院时PaO2较低(G1组:60mmHg,G2组:63.7mmHg,p = 0.02;G2组:63.7mmHg,p = 0.023),二氧化碳(CO2)水平较高(p = 0.001),其特点是无创通气(NIV)使用率较高(p = 0.044)和有创机械通气使用率较高(p = 0.011)。G2组患者总体生存率较好(p = 0.002)。

结论

支气管扩张是慢性阻塞性肺疾病患者预后不良的一个指标,特别是由于加重的发生率和严重程度、气道阻塞和死亡率较高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b0a/7813652/a8224ee31719/PAMJ-37-200-g001.jpg

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