北京协和医院136例支气管扩张症住院患者临床特征分析

发布时间：2018-05-30 12:59

本文选题：支气管扩张症 + 病因　；参考：《中国医学科学院学报》2014年01期

【摘要】：目的总结住院支气管扩张症患者的临床特征,增进对支气管扩张症的认识。方法回顾性分析了2010年1月至2012年12月在北京协和医院住院经高分辨CT确诊的136例支气管扩张症患者的临床资料。结果 136例患者中,男61例(44.9%),女75例(55.1%),平均年龄(57.7±16.3)岁,平均病程(17.2±15.8)年。77.2%(105/136)的患者未能明确病因;既往感染为最主要病因,占14.7%(20/136),其中多为结核感染。主要症状为咳嗽、咳痰。支气管扩张类型为柱状37.8%(37/98)、囊柱状40.8%(40/98)、囊状21.4%(21/98)。多为多肺叶受累,占77.2%(105/136);以左肺下叶受累最多,为76.5%(104/136)。77例住院期间行肺功能检查,其中61.0%(47/77)有阻塞性通气功能障碍。各类型支气管扩张症间1秒用力呼气容积(FEV1)(P=0.918)、用力肺活量(FVC)(P=0.982)及FEV1/FVC(P=0.211)占预计值百分比的差异均无统计学意义。痰培养中以铜绿假单胞菌阳性最多,药敏提示对多数广谱抗生素均敏感。囊状支气管扩张症患者现症感染比例高,易闻及湿罗音。结论本组支气管扩张症患者以中老年女性为多。既往感染,特别是结核感染可能是主要病因。临床症状主要表现为咳嗽、咳痰,肺功能常示阻塞性通气功能障碍,支气管扩张分布多为双肺弥漫性,双下肺为著,特别是左下肺受累最多。囊状支气管扩张可能为病情较重类型,影像学发现此类支气管扩张需引起重视。
[Abstract]:Objective to summarize the clinical features of patients with bronchiectasis and to improve the understanding of bronchiectasis. Methods the clinical data of 136 cases of bronchiectasis diagnosed by high resolution CT from January 2010 to December 2012 in Peking Union Hospital were retrospectively analyzed. Results among 136 patients, 61 males (44.9%) and 75 females (55.1%), mean age (57.7 卤16.3) years and mean course of disease (17.2 卤15.8) years, 107.5 / 136), had no definite etiology, and previous infection was the most important cause, accounting for 14.720% 136g, most of which were tuberculosis infection. The main symptoms are cough and expectoration. The type of bronchiectasis is columnar 37 / 98, Cystoid 40 / 98, Cystoid 21.4a 21 / 98. Most of them were involved in multiple lobes, accounting for 77.2% of 105% 136L, and the lower lobe of left lung was the most involved, 76.5104 / 1360.77 cases underwent pulmonary function examination during hospitalization, of which 61.0% 47 / 77 had obstructive ventilation dysfunction. There was no significant difference in the percentage of FEV1 / FVCU P0. 982 and FEV1 / FVCU P0. 211 between different types of bronchiectasis in terms of FEV1 / FVCU P0. 918, forced vital capacity (RV) and FEV 1 / FVCU PJ 0. 211) in each type of bronchiectasis, there was no significant difference in the percentage of predicted values between the two groups. Pseudomonas aeruginosa was the most positive in sputum culture. The present infection rate in patients with cystic bronchiectasis is high, easy to hear and moist rale. Conclusion the patients with bronchiectasis are mostly middle-aged women. Previous infection, especially tuberculosis infection, may be the main cause. The main clinical symptoms were cough, expectoration, pulmonary function, obstructive ventilation dysfunction, bronchiectasis distribution was diffuse in both lungs, double lower lung was the most involved, especially the left lower lung. Cystic bronchiectasis may be a severe type of disease, imaging findings of such bronchiectasis need attention.
【作者单位】：中国医学科学院
【分类号】：R562.22

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