老年支气管扩张患者临床特点及炎症特征分析

Clinical and Inflammatory Characteristics of Bronchiectasis in the Elderly

目的探讨老年支气管扩张患者的临床特点及炎症特征,为老年支气管扩张患者的诊断及防治提供依据。方法收集住院支气管扩张患者487例,按照年龄分为老年组(n=306)和非老年组(n=181),比较2组患者临床、检验、肺功能及影像检查资料及诱导痰、外周血CRP、PCT及IL-17等水平。结果老年组相较非老年组病程长短的差异无统计学意义(P>0.05);老年组发热、胸痛、气喘发生率及SGQR评分均高于非老年组(P<0.05),老年组肺过度充气、透光度增高、肺大疱和肺气肿的发生率高于非老年组(P<0.01),FEV1%pred值低于非老年组(P<0.01),老年组诱导痰IL-17及血清IL-17水平均高于非老年组(P<0.05)。结论支气管扩张可发生于各年龄,老年患者相比非老年患者临床症状重、炎症指标高、肺通气功能及生活质量差。

Objective To explore the clinical and inflammatory characteristics of bronchiectasis in the elderly so as to provide the basis for diagnosis and treatment.Methods 487 cases with bronchiectasis were enrolled and divided,according to the age,into 2 groups:the elderly group(n=306)and non-elderly group(n=181);a comparative study was made between the 2 groups in clinical data,lab tests,pulmonary function and imaging examinations as well as the levels of CRP,PCT and IL-17 in peripheral blood and the level of IL-17 in induced sputum.Results There existed no statistical difference in disease course between the 2 groups(P >0.05);the occurrences of fever,chest pain,asthma and the SGQR scores in elderly group were higher than those in non-elderly group(P<0.05)and the same in the occurrence of pulmonary hyperinflation,increased transparency,pulmonary bullae and emphysema(P<0.01);FEV1%pred was lower and the level of IL-17 in peripheral blood and the level of IL-17 in induced sputum were higher in elderly group than those in non-elderly group(P<0.05).Conclusions Bronchiectasis may occur at various ages,the elderly cases usually have more serious clinical symptoms,higher inflammatory index,poorer pulmonary ventilation function and poorer quality of life than non-elderly cases.