慢性阻塞性肺疾病合并支气管扩张患者的临床特点分析

Analysis of clinical characteristics of COPD patients complicated with bronchiectasis

目的：分析慢性阻塞性肺疾病（简称慢阻肺）合并支气管扩张患者的临床特征，提高对该病的认识和诊断水平。方法选择我院2011～2013年间住院的112例慢阻肺患者为研究对象，分为慢阻肺合并支气管扩张组（n=48）和慢阻肺组（n=64），比较两组患者的临床特征、胸部高分辨率CT（HRCT）、肺功能、血气分析表现，随访6个月记录两组患者的急性加重次数。结果慢阻肺合并支气管扩张组BMI低于慢阻肺组；日常咳脓性痰者比例、入院前一年的住院次数均明显高于慢阻肺组（P值分别〈0．01与0．05）。慢阻肺合并支气管扩张组患者FEV1% pred、FEV1/FVC、FVC% pred、DLCO%pred降低较单纯慢阻肺组更为显著（ P〈0．05）。慢阻肺合并支气管扩张组6个月内平均每人发生急性加重次数（1．47±0．85次）；高于慢阻肺组患者（1．06±0．54次），两者比较差异有统计学意义（P〈0．05）。结论慢阻肺患者中合并支气管扩张者较为常见，合并支气管扩张的慢阻肺患者肺功能下降更为明显，发生急性加重的风险增加。

Objective To explore the clinical characteristics of COPD patients complicated with bronchiectasis, so as to improve the diagnostic ability and understanding of the disease. Methods The study selected 112 pa-tients to compare their clinical characteristics, HRCT, pulmonary function and blood gas analysis, which included 48 cases of COPD patients （ the COPD group） and 64 cases of COPD patients complicated with bronchiectasis （ the study group）. The times of acute exacerbation in the 6-month follow-up were also observed. Results BMI was lower in the study group than in the COPD group. The proportion of daily purulent sputum and hospitalization in the previous year was higher in the study group than in the COPD group. The decline of FEV11% pred, FEV1/FVC, FVC% pred and DLCO%pred was more pronounced in the study group than in the COPD group （P〈0. 05）. The times of exacerbation during the 6-month follow-up was （1. 47 ± 0. 85） times in the study group, which was higher than that of the COPD group （1. 06 ± 0. 54）. Conclusion It is very common that COPD patients are complicated with bronchiectasis, who show a lower lung function and have a higher risk of exacerbation.