Department of Pediatrics, Bezmialem Vakif University Medical Faculty, Istanbul, Turkey.
Department of Pediatric Pulmonology, Istanbul Cerrahpasa University Medical Faculty, Istanbul, Turkey.
Pediatr Allergy Immunol Pulmonol. 2021 Jun;34(2):46-52. doi: 10.1089/ped.2020.1319. Epub 2021 May 14.
Published data on the correlations of bronchoscopy findings with microbiological, radiological, and pulmonary function test results in children with noncystic fibrosis (CF) bronchiectasis (BE) are unavailable. The aims of this study were to evaluate relationships between Bronchoscopic appearance and secretion scoring, microbiological growth, radiological severity level, and pulmonary function tests in patients with non-CF BE. Children with non-CF BE were identified and collected over a 6-year period. Their medical charts and radiologic and bronchoscopic notes were retrospectively reviewed. The study population consisted of 54 female and 49 male patients with a mean age of 11.7 ± 3.4 years. In the classification according to the bronchoscopic secretion score, Grade I was found in 2, Grade II in 4, Grade III in 9, Grade IV in 17, Grade V in 25, and Grade VI in 46 patients. When evaluated according to the Bhalla scoring system, 45 patients had mild BE, 37 had moderate BE, and 21 had severe BE. Microbial growth was detected in bronchoalveolar lavage fluid from 50 of the patients. Forced expiratory volume in 1 s (FEV) and functional vital capacity decreased with increasing bronchoscopic secretion grade ( = 0.048 and = 0.04), respectively. The degree of radiological severity increased in parallel with the bronchoscopic secretion score ( = 0.007). However, no relationship was detected between microbiological growth rate and radiological findings ( = 0.403). This study showed that bronchoscopic evaluation and especially scoring of secretions correlate with severe clinical condition, decrease in pulmonary function test, worsening in radiology scores, and increase in microbiological bacterial load in patients. Flexible endoscopic bronchoscopy should be kept in mind in the initial evaluation of non-CF BE patients.
关于非囊性纤维化(CF)支气管扩张症(BE)患儿支气管镜检查结果与微生物学、影像学和肺功能检查结果相关性的已有数据尚不可用。本研究旨在评估非 CF-BE 患者的支气管镜外观与分泌物评分、微生物生长、影像学严重程度分级和肺功能检查之间的关系。
在 6 年的时间里,我们确定并收集了非 CF-BE 患儿的病历、影像学和支气管镜记录,并进行了回顾性分析。
研究人群由 54 名女性和 49 名男性组成,平均年龄为 11.7±3.4 岁。根据支气管镜分泌物评分进行分类,1 级为 2 例,2 级为 4 例,3 级为 9 例,4 级为 17 例,5 级为 25 例,6 级为 46 例。根据 Bhalla 评分系统评估,45 例为轻度 BE,37 例为中度 BE,21 例为重度 BE。50 例患儿的支气管肺泡灌洗液中检测到微生物生长。第 1 秒用力呼气容积(FEV)和功能肺活量随着支气管镜分泌物分级的增加而下降(=0.048 和=0.04)。影像学严重程度与支气管镜分泌物评分呈平行增加(=0.007)。然而,微生物生长率与影像学发现之间没有相关性(=0.403)。
本研究表明,支气管镜评估,特别是分泌物评分与严重临床状况、肺功能检查下降、影像学评分恶化以及微生物细菌负荷增加相关。在非 CF-BE 患者的初始评估中应考虑使用灵活的支气管镜检查。