2016-2020年武汉市硚口区慢性阻塞性肺疾病患者合并支气管扩张症及影响因素

Investigation of bronchiectasis in COPD patients from 2016 to 2020 in Qiaokou District of Wuhan and its influencing factors

目的分析武汉市硚口区2016—2020年慢性阻塞性肺疾病(COPD)患者合并支气管扩张症特征及影响因素。方法回顾性分析2016年1月至2020年12月武汉市第一医院收治的412例武汉市硚口区COPD患者的临床资料。根据胸部高分辨CT检查是否合并支气管扩张症将患者分为合并组(162例)和未合并组(250例)。比较两组基本资料、实验室指标、肺功能指标差异。采用多因素logistic回归分析探讨2016—2020年武汉市硚口区COPD患者合并支气管扩张症的相关因素。结果合并组患者PO_(2)、白蛋白水平均低于未合并组(P<0.05),但吸烟史、肺结核史、症状持续时间、PCO_(2)、血红蛋白、痰培养阳性和铜绿假单胞菌感染比例均高于未合并组(P<0.05)。合并组FEV1、FVC、FEV1/FVC、FEV1%pred值均低于未合并组(P<0.05)。吸烟史(OR=3.39,95%CI:2.02~5.56)、肺结核史(OR=3.09,95%CI:1.85~5.16)、症状持续时间(OR=3.48,95%CI:1.93~6.29)、铜绿假单胞菌感染(OR=3.76,95%CI:1.98~7.15)均为影响COPD合并支气管扩张症的危险因素(P<0.05)。结论武汉市硚口区2016—2020年COPD合并支气管扩张症患者肺功能下降更明显,且吸烟史、肺结核史、症状持续时间、铜绿假单胞菌感染是影响COPD患者合并支气管扩张症的危险因素。

Objective To analyze the characteristics and influencing factors of bronchiectasis in patients with chronic obstructive pulmonary disease(COPD)in Qiaokou District of Wuhan from 2016 to 2020.Methods The clinical data of 412 COPD patients admitted to Wuhan First Hospital from January 2016 to December 2020 were retrospectively analyzed.Patients were divided into combined group(162 cases)and non-combined group(250 cases)according to whether they were complicated with bronchiectasis by the high-resolution chest CT examination.The differences in basic data,laboratory indexes,and lung function indexes between the two groups of patients were compared.Multivariate logistic regression analysis was used to explore the influencing factors for COPD patients complicated with bronchiectasis from 2016 to 2020 in Qiaokou District of Wuhan.Results The proportion of COPD patients with smoking history,the proportion of pulmonary tuberculosis history,the proportion of producing yellow-white sputum and yellow sputum,and the duration of symptoms in the combined group were significantly higher than those in the non-combined group(P<0.05).The PO_(2) and albumin levels of patients in the combined group were lower than those in the non-combined group(P<0.05),but the proportion of PCO_(2),hemoglobin,sputum culture positive,and the proportion of Pseudomonas aeruginosa infection were significantly higher than those in the non-combined group(P<0.05).The values of the FEV1,FVC,FEV1/FVC,and FEV1%pred of patients in the combined group were significantly lower than those in the non-combined group(P<0.05).The results of multivariate logistic regression analysis showed that smoking history(OR=3.39,95%CI:2.02-5.56),pulmonary tuberculosis history(OR=3.09,95%CI:1.85-5.16),duration of symptoms(OR=3.48,95%CI:1.93-6.29)and Pseudomonas aeruginosa infection(OR=3.76,95%CI:1.98-7.15)were the risk factors affecting COPD with bronchiectasis(P<0.05).Conclusion The pulmonary function of COPD patients with bronchiectasis decreased significantly in Qiaokou District of Wuhan from 2016 to 2020.The smoking history,tuberculosis history,duration of symptoms,and Pseudomonas aeruginosa infection are risk factors affecting COPD patients complicated with bronchiectasis.