Characteristics Of Clinical Feature In The Patients With Chronic Obstructive Pulmonary Disease With Bronchiectasis

ObjectiveThe purpose of this paper is to provide the best guidance for the follow-up treatment and management of bronchiectasis-COPD overlap syndrome(BCOS) by analyzing the clinical characteristics of chronic obstructive pulmonary disease complicated with bronchiectasis.MethodsA total of 310 patients with acute exacerbation of chronic obstructive pulmonary disease(COPD) who were hospitalized in the respiratory department of our hospital from January 2016 to January 2018 were selected to determine whether they were complicated with bronchiectasis according to the high resolution CT of the chest.To analyze the clinical characteristics of patients with chronic obstructive pulmonary disease complicated with bronchiectasis.It includes general condition(age,sex,smoking history,course of disease),clinical symptoms(cough,expectoration,chest tightness,hemoptysis),serum indexes(inflammation index,erythrocyte sedimentation rate,cellular immune function),lung function,chest HRCT performance,sputum culture and so on.ResultsIn 310 patients with chronic obstructive pulmonary disease,the prevalence rate of bronchiectasis was 25.8%,and the prevalence rate increased with the increase of the severity of chronic obstructive pulmonary disease.There were 80 cases of chronic obstructive pulmonary disease complicated with bronchiectasis,male 63.8%,mean age 72.4 ±10.1 years,and 230 cases of chronic obstructive pulmonary disease group,male 74.4%,mean age 74.0 ±10.7 years old.The chronic obstructive pulmonary disease complicated with bronchiectasis group had more severe cough and purulent sputum symptoms than the chronic obstructive pulmonary disease group(P=0.004),and the blood inflammation indexes such as white blood cell count(9.7vs8.2,P=0.005) and hypersensitive C-reactive protein(67.1vs31.0,P=0.011) were higher than those in the chronic obstructivepulmonary disease group.The lung function of FEV1/FVC(51.6vs54.5,P=0.048),FEV1%pred(46.4vs57.8,P=0.000) and FVC%pred(66.5vs79.5,P=0.000) was even worse,the course of antibiotic treatment was longer(11.6vs9.7,P=0.008),the frequency of admission was more frequent because of acute aggravation(1.2vs1.0,P=0.039),and the isolation rate of sputum culture microorganisms was higher(14.3vs10.0,P=0.000),especially Pseudomonas aeruginosa,the average hospital stay and hospitalization cost were higher(24089.2vs15895.2,P=0.000).Conclusion1.Chronic obstructive pulmonary disease with bronchiectasis may be a special phenotype of chronic obstructive pulmonary disease,bronchiectasis-COPD overlap syndrome,but it is still only a hypothesis,a large number of prospective,randomized,multicenter studies are needed to confirm it.;2.Chronic obstructive pulmonary disease with bronchiectasis is a more serious disease,characterized by the deterioration of clinical symptoms,the decline of pulmonary function,the existence of more pathogenic microorganisms,more frequent acute exacerbation and worse prognosis.