简介:支气管扩张是一种慢性进行性呼吸系统疾病,其特征是支气管永久性扩张。这是一种复杂的疾病,有许多不同的病因,合并症,和异类演示。我们知道,缺乏描述局灶性和多灶性支气管扩张的差异和比较特征的研究。这项研究的目的是确定临床特征表现的差异,局灶性和多灶性支气管扩张的严重程度或分布,和预后影响。方法:纳入126例CT(CT)证实的支气管扩张患者。基线特征,包括年龄,性别,吸烟史,记录呼吸道症状,特别注意咯血的外观,身体质量指数,和合并症。记录通过CT扫描确定的支气管扩张的类型和指示放射学严重程度的修改的Reiff评分。患者分为两组(I为局灶性,II为多灶性)。结果:年龄差异无统计学意义,吸烟状况,合并症,两组之间的BMI。多灶性与女性比例明显较高相关(p=0.014),咯血率(p=0.023),以及住院次数,但不是免疫缺陷的恶化和患病率(p=0.049)。重要的是,大量的多灶性受试者患有中度严重的支气管扩张,感染后和哮喘相关表型在该组中占主导地位。出乎意料的是,囊性和静脉曲张放射学表型(需要更多的时间来发展)在病灶组中更占优势.在多病灶组和病灶组中同样观察到圆柱形表型。结论:我们的研究表明,多灶性与年龄无关,加重次数,或放射学表型,但它似乎与临床感染后表型有关,免疫缺陷,频繁住院,和严重性。因此,在这些患者中,多灶性支气管扩张的存在可能是严重程度和不良结局的生物标志物.
Introduction: Bronchiectasis is a chronic progressive respiratory disease characterized by permanent dilatation of the bronchi. It is a complex condition with numerous different etiologies, co-morbidities, and a heterogeneous presentation. As we know, there is a lack of studies that describe the differences and compare the characteristics between focal and
multifocal bronchiectasis. The aim of this study is to identify differences in clinical characteristics presentation, severity or distribution in focal and
multifocal bronchiectasis, and prognostic implications. Methods: 126 patients with computed tomography (CT)-verified bronchiectasis were enrolled. Baseline characteristics that included age, sex, smoking history, and respiratory symptoms were recorded, with special attention paid to hemoptysis appearance, body mass index, and comorbidities. The type of bronchiectasis determined by CT scan and the modified Reiff scores indicating radiological severity were recorded. Patients were divided in two groups (I is focal and II is
multifocal). Results: There were no statistically significant differences in age, smoking status, comorbidity, and BMI between the two groups. Multifocality was associated with a significantly higher proportion of females (p = 0.014), the rate of hemoptysis (p = 0.023), and the number of hospitalizations, but not of exacerbations and prevalence of immunodeficiency (p = 0.049). Significantly, a high number of subjects with multifocality had bronchiectasis of moderate severity, and post-infective and asthma-associated phenotypes were the dominant in this group. Unexpectedly, the cystic and varicose radiological phenotype (which need more time to develop) were more dominant in the focal group. The cylindrical phenotype was equally observed in the
multifocal and focal groups. Conclusions: Our study suggests that multifocality is not related to age, number of exacerbations, or radiological phenotype, but it seems to be associated with the clinical post-infective phenotype, immunodeficiency, frequent hospitalizations, and severity. Thus, the presence of
multifocal bronchiectasis may act as a biomarker of severity and poor outcomes in these patients.