Zhonghua Jie He He Hu Xi Za Zhi. 2024 Oct 12;47(10):921-932. doi: 10.3760/cma.j.cn112147-20240606-00315.
Bronchiectasis is a highly heterogeneous chronic airway disease for which accurate etiological diagnosis is crucial for effective management. A group of experts from the China Bronchiectasis Alliance and the Infection Assembly of the Chinese Thoracic Society conducted a comprehensive review of recent research into the etiology of bronchiectasis. Using the widely accepted Delphi methodology, the experts reached a consensus on the etiological diagnosis of bronchiectasis through multiple rounds of discussion and revision. The consensus is divided into four sections: the definition and classification of the etiology of bronchiectasis, the etiological diagnostic procedures for bronchiectasis, the treatable causes of bronchiectasis, and other causes of bronchiectasis. The ultimate goal of this consensus is to improve the diagnostic accuracy and optimize the management of bronchiectasis in China. The main recommendations of Section 1 focused on chest thin-section computed tomography (CT) for the diagnosis of bronchiectasis and the etiological classification. The main recommendations of Section 2 focused on the medical history collection for bronchiectasis and the etiological diagnostic protocol for bronchiectasis. The main recommendations of Section 3 focused on the recommendations of the diagnosis of bronchiectasis secondary to COPD, the diagnosis of bronchiectasis due to asthma, diffuse pan-bronchiolitis, allergic bronchopulmonary aspergillosis, connective tissue disease (CTD)-related bronchiectasis or gastroesophageal reflux disease (GERD)-related bronchiectasis. The main recommendations of Section 4 focused on suspected primary ciliary dyskinesia (PCD)-associated bronchiectasis, cystic fibrosis and the diagnosis of congenital airway malformations.
支气管扩张症是一种高度异质性的慢性气道疾病,准确的病因诊断对于有效管理至关重要。中国支气管扩张症联盟和中华医学会呼吸病学分会感染学组的一组专家对支气管扩张症病因的近期研究进行了全面综述。专家们采用广泛认可的德尔菲法,通过多轮讨论和修订,就支气管扩张症的病因诊断达成了共识。该共识分为四个部分:支气管扩张症病因的定义和分类、支气管扩张症的病因诊断程序、支气管扩张症的可治疗病因以及支气管扩张症的其他病因。该共识的最终目标是提高中国支气管扩张症的诊断准确性并优化其管理。第1部分的主要建议集中在胸部薄层计算机断层扫描(CT)用于支气管扩张症的诊断和病因分类。第2部分的主要建议集中在支气管扩张症的病史采集和支气管扩张症的病因诊断方案。第3部分的主要建议集中在慢性阻塞性肺疾病(COPD)继发支气管扩张症的诊断、哮喘、弥漫性泛细支气管炎、变应性支气管肺曲霉病、结缔组织病(CTD)相关支气管扩张症或胃食管反流病(GERD)相关支气管扩张症的诊断建议。第4部分的主要建议集中在疑似原发性纤毛运动障碍(PCD)相关支气管扩张症、囊性纤维化和先天性气道畸形的诊断。