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哮喘合并支气管扩张症的临床特征:系统评价和荟萃分析。

Clinical features of asthma with comorbid bronchiectasis: A systematic review and meta-analysis.

机构信息

Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Medicine (Baltimore). 2021 Jan 29;100(4):e23858. doi: 10.1097/MD.0000000000023858.

Abstract

BACKGROUND

This meta-analysis aimed to systematically estimate the prevalence of comorbid bronchiectasis in patients with asthma and to summarize its clinical impact.

METHODS

Embase, PubMed, and Cochrane Library electronic databases were searched to identify relevant studies published from inception until March 2020.

STUDY SELECTION

Studies were included if bronchiectasis was identified by high-resolution computed tomography. Outcomes included the prevalence of bronchiectasis and its association with demographic characteristics and indicators of asthma severity, including results of lung function tests and the number of exacerbations.

RESULTS

Five observational studies with 839 patients were included. Overall, the mean prevalence of bronchiectasis in patients with asthma was 36.6% (307/839). Patients with comorbid bronchiectasis had lower forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) (MD: -2.71; 95% CI: -3.72 to -1.69) and more frequent exacerbations (MD: 0.68; 95% CI: 0.03 to 1.33) than those with asthma alone, and there was no significant difference of sex, duration of asthma and serum levels of immunoglobulin(Ig)Es between asthmatic patients with or without bronchiectasis.

CONCLUSION

The presence of bronchiectasis in patients with asthma was associated with greater asthma severity. There are important therapeutic implications of identifying bronchiectasis in asthmatic patients.

摘要

背景

本荟萃分析旨在系统评估哮喘患者合并支气管扩张症的患病率,并总结其临床影响。

方法

检索 Embase、PubMed 和 Cochrane Library 电子数据库,以确定从建库至 2020 年 3 月发表的相关研究。

研究选择

如果支气管扩张症是通过高分辨率计算机断层扫描确定的,则纳入研究。结局包括支气管扩张症的患病率及其与人口统计学特征和哮喘严重程度指标的关系,包括肺功能检查结果和加重次数。

结果

纳入 5 项观察性研究共 839 例患者。总体而言,哮喘患者中支气管扩张症的平均患病率为 36.6%(307/839)。合并支气管扩张症的患者用力呼气量/用力肺活量(FEV1/FVC)较低(MD:-2.71;95%CI:-3.72 至-1.69),且加重次数更多(MD:0.68;95%CI:0.03 至 1.33),而单纯哮喘患者的性别、哮喘持续时间和血清免疫球蛋白(Ig)E 水平无显著差异。

结论

哮喘患者存在支气管扩张症与哮喘严重程度增加有关。在哮喘患者中识别支气管扩张症具有重要的治疗意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb19/7850679/58ff7613bef1/medi-100-e23858-g001.jpg

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