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[与慢性阻塞性肺疾病相关的支气管扩张:临床及演变特征]

[Bronchiectasis associated with chronic obstructive pulmonary disease: clinical and evolutionary profile].

作者信息

Habouria Chaima, Bachouch Imen, Belloumi Nidhal, Harizi Chahida, Chermiti Fatma, Fenniche Soraya

机构信息

Service de Pneumologie 4, Hôpital Abderrahmen Mami, Ariana, Faculté de Médecine de Tunis, Université Tunis, El Manar, Tunisie.

Service d´Épidémiologie et de Statistique, Hôpital Abderrahmen Mami, Ariana, Faculté de Médecine de Tunis, Université Tunis, El Manar, Tunisie.

出版信息

Pan Afr Med J. 2020 Nov 18;37:249. doi: 10.11604/pamj.2020.37.249.25023. eCollection 2020.

Abstract

INTRODUCTION

in recent years, the combination of bronchiectases (BRs) and chronic obstructive pulmonary disease (COPD) has been described as a potential new phenotype of COPD due to its clinical features and different prognosis. The purpose of this study was to analyse the clinical profile and paraclinical features of COPD in patients with BRs and to determine the impact of BRs on disease progression.

METHODS

we conducted a retrospective study of 100 patients diagnosed with COPD and treated in the Department of Pneumology 4 at the Abderrahmane Mami Hospital between 2014 and 2018. Patients were divided into two groups: group 1: patients with COPD associated with BRs (n=50) and group 2: patients with COPD without BRs (n=50). Both groups were matched based on their epidemiological characteristics.

RESULTS

all patients were male, with an average age of 65,9 years. Patients with COPD associated with BRs had a higher rate of ischemic heart disease (p=0.037), more severe breathlessness assessed using the modified Medical Resaerch Council (mMRC≥2) (p=0.02), more severe bronchial obstruction (p=0.005) and a higher prevalence of acute exacerbations (p<0.001) and hospitalizations (p=0.004). In a multivariate study, independent factors associated with BRs were severe bronchial obstruction (OR=9.16), frequent exacerbator phenotype (≥2 exacerbations per year) (OR=1.91) and isolation of germs by cytobacteriological examination of sputum (OR=4.99).

CONCLUSION

COPD associated with BRs could thus be a phenotype distinct from COPD and correlated with a more reserved prognosis.

摘要

引言

近年来,支气管扩张(BRs)与慢性阻塞性肺疾病(COPD)的合并症因其临床特征和不同预后,被描述为COPD一种潜在的新表型。本研究的目的是分析合并BRs的COPD患者的临床概况和辅助检查特征,并确定BRs对疾病进展的影响。

方法

我们对2014年至2018年期间在阿卜杜勒拉赫曼·马米医院呼吸科4接受治疗的100例诊断为COPD的患者进行了回顾性研究。患者分为两组:第1组:合并BRs的COPD患者(n = 50)和第2组:无BRs的COPD患者(n = 50)。两组根据其流行病学特征进行匹配。

结果

所有患者均为男性,平均年龄65.9岁。合并BRs的COPD患者缺血性心脏病发生率更高(p = 0.037),使用改良医学研究委员会(mMRC≥2)评估的呼吸困难更严重(p = 0.02),支气管阻塞更严重(p = 0.005),急性加重(p < 0.001)和住院率(p = 0.004)更高。在多变量研究中,与BRs相关的独立因素为严重支气管阻塞(OR = 9.16)、频繁加重型表型(每年≥2次加重)(OR = 1.91)和痰细胞细菌学检查分离出病菌(OR = 4.99)。

结论

合并BRs的COPD可能是一种与COPD不同的表型,且与更差的预后相关。

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