Clinical Characteristics Of Patients With Bronchiectasis Overlap Asthma

Objective In order to provide a reference for early diagnosis and treatment of patients with bronchiectasis overlap asthma,this study investigate the clinical characteristics of patients with bronchiectasis overlap asthma.Methods The study collects the information of patients who diagnosed as bronchiectasis and bronchiectasis overlap asthma underwent inpatient department of Respiratory Department of the First Affilicated Hospital of Dalian Medical University from December 2013 to December 2017.Bronchiectasis diagnosis refer to 2012 adult bronchoscopy diagnosis and treatment expert consensus,asthma diagnosis refer to the2008 guidelines for the prevention and treatment of asthma.Select the patients who met the inclusion criteria and who were checked by high-resolution computerized tomography(HRCT),pulmonary function test,bronchial dilation test,provocation test or peak expiratory flow(PEF)and their mutation rate.According to the results of bronchial dilation test,provocation test,or PEF and its mutation rate,patients whose test results were positive were divided into the bronchiectasis overlap asthma coexisting group,A total of 74 cases,the test results were negative were devided into the bronchiectasis group,a total of 36 cases.Then statistically analyze the two groups baseline data such as sex,age,smoking history and allergy history,clinical symptoms and signs,sputum culture,serum IgE,pulmonary function test results.The measurement data in each group were in accordance with the normal score then expressed as mean ±standard deviation(X ± S),t-test was used for comparison between groups,and the count data was expressed as frequency(%),using chi-square test.P <0.05 for the difference was statistically significant.result:1.In terms of general baseline data,the average duration of illness in patients with bronchiectasis overlap asthma coexisting group was(year)22.11 ± 18.801,and the average duration of bronchiectasis group was(year)11.81 ± 14.077,with significant difference(P < 0.05).2.In the history of allergic diseases,15 patients with allergic rhinitis(23.0%)and2 patients with allergic laryngitis(2.7%)were found in 74 patients with bronchiectasis overlap asthma coexisting group,the difference was statistically significant(P <0.05).There were 23 cases of 74 patients with bronchiectasis and asthma coexisting group were allergic to pollen,dust mites,mutton,fish,shrimp,jellyfish and other substances and 31.1% were allergic to penicillins,cephalosporins,shuanghuanglian and levofloxacin,and the difference was statistically significant(P <0.05).3.In terms of clinical manifestations,71 of the 74 subjects with bronchiectasis and asthma combined had wheezing symptoms(94.6%),and 71(71.4% %),6 cases of wet rales(8.1%),24 cases of dry rales and wet rales(32.4%),the difference was statistically significant(P <0.05).4.In bronchiectasis and asthma coexisting group 13 cases(20.3%)had positive sputum culture results,of which 6 were Candida albicans,2 were Klebsiella pneumoniae,2 were Pseudomonas aeruginosa,2 cases of cloacae,1 case of Staphylococcus aureus,3 cases(8.3%)of positive sputum culture results in simple bronchiectasis group,including 1 case of Klebsiella pneumoniae,1 case of Enterococcus faecalis,1 case of Enterobacter cloacae For example,there was no significant difference between the two groups in sputum culture positive rate(P>0.05),while the bronchiectasis overlap asthma coexisting group with sputum culture results for Candida albicans than the bronchiectasis group.In the total serum IgE,the serum total IgE level of bronchiectasis and asthma coexisting group was 756.476 ±652.636 IU / ml,and the total IgE level of bronchiectasis group was 62.470 ± 43.560 IU / ml.The difference was statistically significant(P <0.05).5.In terms of lung function,before inhalation of bronchodilator lung indicators ofthe two groups of study indicators such as FEV1(L),FEV1(%),FEV1 / FVC(%),FEF25-75%(sec),FEF25-75%(%),MVV difference was statistically significant(P<0.05).The bronchodilator inhalation bronchodilator bronchiectasis asthma combined group in FVC,FEV1,FEV1 / FVC,FEF25-75% improvement rate than the simple branch expansion group was significantly,the difference was statistically significant(P<0.05).There was significant difference between the two groups in raw airway resistance index Raw,sGaw(P <0.05)Conclusions :1.Patients with bronchiectasis overlap asthma also have more food and drug allergy history,Patients with bronchiectasis overlap asthma also have allergic laryngitis and allergic rhinitis and other allergic diseases.2.The bronchiectasis overlap asthma coexisting group of 74 patients,6 cases of sputum culture Candida albicans positive,simple bronchiectasis group without sputum culture Candida albicans,which can be inferred Candida albicans may contain some allergic components Cause airway hyperresponsiveness,induce asthma.3.The bronchiectasis overlap asthma coexisting group of serum total IgE levels higher than patients with simple branch and expansion.4.Patients with bronchiectasis and asthma combined response to poor pulmonary ventilation function indexindicators,greater airway resistance,inhaled bronchodilator lung function will have a more significant improvement.