| Objectivechronic obstructive pulmonary disease（COPD）and bronchiectasis are common respiratory diseases.The prognosis of patients with chronic obstructive pulmonary disease combined with bronchiectasis is poor.This study compares the clinical manifestation of patients with chronic obstructive pulmonary disease combined with or without bronchiectasis in acute exacerbation,clinical data such as expression and inflammatory index,sputum specimen and pathogenic microorganism examination were studied to provide evidence for early diagnosis,treatment and prevention of COPD combined with bronchiectasis.MethodThis study was carried out in hospital of Dalian Medical University from January2014 to January 2018.Patients who met the diagnostic criteria for COPD in the GOLD guidelineswerecollected.Theendobronchialdiameter/pulmonaryartery diameter（B/A）>1.5 showed by CT suggests bronchiectasis.Asthma,Interstitial lung disease,Liver,kidney,digestive diseases and tuberculosis,hyperthyroidism,malignant tumors and other wasting diseases were excluded.The patients were divided into two groups:A group is COPD combined with bronchiectasis and B group is COPD alone.The clinical data of these patients were collected,and the results were analyzed using SPSS 20.0 software.The single sample K-S was used to test the normality.The t test and the Mann-Whitney U test were used.The Logistic regression model was used to analyze the Risk factors of chronic obstructive pulmonary disease combined with bronchiectasis.The P value less than 0.05 was considered statistically significant.Result1.Of the 328 patients,122 patients had chronic obstructive pulmonary disease（COPD）complicated with bronchiectasis（group A）,including 52 women（42.6%）.206cases had chronic obstructive pulmonary disease（group B）,62 cases（30%）were female.And the proportion of women in group A was higher than that in group B,the difference was significant（P=0.02）.The length of stay,hospitalization expenses and moderate and severe ratio of pulmonary ventilatory disorders of patients in the A group were higher than those in the B group（P=0.019,P<0.01,P<0.01）,and the BMI in the A group was lower than that of the B group（P=0.03）.2.The inflammatory markers in the acute exacerbation of COPD combined with bronchiectasis（A group）and COPD alone（B group）:the WBC,CRP,and PCT in group A were significantly higher than those in group B,and the difference was statistically significant（P<0.05）.3.The general situation of chronic obstructive pulmonary disease combined with bronchiectasis group（group A）and simple chronic obstructive pulmonary disease group（group B）in the acute exacerbation period:the difference of breathe hard,blood gas PO2,or PCO2 was not statistically significant（P=0.81,P=0.053,P=0.11）.The daily sputum excretion and the amount of purulent sputum expectoration in group A were higher than those in group B,and the difference was statistically significant（P<0.05,P<0.05）.The infection rate of Pseudomonas aeruginosa in group A was higher than that in group B,and the difference was statistically significant（P<0.01）.4.Logistic regression model analysis of the risk factors for patients with chronic obstructive pulmonary disease combined with or without bronchiectasis:the risk of bronchiectasis in patients with chronic obstructive pulmonary disease with purulent sputum is 1.506 times as high as that of patients without purulent sputum（P<0.01）;The risk of bronchiectasis of chronic obstructive pulmonary disease patients with Pseudomonas aeruginosa in sputum is 3.164 times that of those found in sputum without Pseudomonas aeruginosa（P<0.01）.ConclusionThe proportion of women in chronic obstructive pulmonary disease combined with bronchiectasis group was higher than that in group B.In the acute exacerbation period,the inflammatory markers in COPD with bronchiectasis were higher than that of patients with simple chronic obstructive pulmonary disease.Daily sputum excretion,purulent sputum expectoration,length of hospital stay and hospitalization expenses were higher.In patients with chronic obstructive pulmonary disease,Pseudomonas aeruginosa with expectoration and purulent sputum expectorationis more susceptible to bronchiectasis. |
