Prevalence and clinical implications of bronchiectasis in patients with overlapping asthma and chronic rhinosinusitis: a single-center prospective study.
Prevalence and clinical implications of bronchiectasis in patients with overlapping asthma and chronic rhinosinusitis: a single-center prospective study.
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患有重叠哮喘和慢性鼻窦炎的患者支气管扩张的患病率和临床意义：一项单中心前瞻性研究。
DOI：
10.1186/s12890-021-01575-7
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发表时间：
2021-07-05
影响因子：
3.1
通讯作者：
Zhang L
中科院分区：
文献类型：
--
作者：
Sheng H;Yao X;Wang X;Wang Y;Liu X;Zhang L
作为一种典型的“联合气道”疾病，哮喘-慢性鼻窦炎（CRS）重叠近年来受到越来越多的关注。支气管扩张症是一种异质性疾病，涉及多种疾病。支气管扩张是否存在以及与哮喘CRS患者的相关性尚未完全阐明。本研究的目的是探讨重叠哮喘和CRS患者中支气管扩张的存在和特征。本报告描述了一项前瞻性研究，连续哮喘CRS患者。支气管扩张的诊断和严重程度通过胸部高分辨率计算机断层扫描（HRCT）、Smith放射学评分和Bhalla评分系统获得。CRS严重程度通过鼻窦CT和Lund-Mackay（LM）评分系统进行评估。分析支气管扩张与临床资料、呼出气一氧化氮、外周血嗜酸性粒细胞计数及肺功能的相关性。在176例哮喘合并CRS患者中，72例（40.91%）诊断为支气管扩张。哮喘合并CRS合并重叠支气管扩张患者鼻息肉发生率较高（P = 0.004），LM评分较高（P = 0.044），过去12个月内≥ 1次哮喘重度急性发作的比例较高（P = 0.003），较低的支气管扩张剂后第一秒用力呼气量（FEV 1）%预测值（P = 0.006），外周血嗜酸性粒细胞计数升高（P = 0.022）。Smith和Bhalla评分与NP呈正相关，与FEV1%预测值和体重指数呈负相关。FEV1%预测值≤ 71.40%、外周血嗜酸性粒细胞计数> 0.60 × 109/L、存在NP和过去12个月内≥ 1次哮喘重度急性发作的临界值可用于区分哮喘-CRS患者中的支气管扩张。支气管扩张通常在哮喘-CRS患者中重叠。支气管扩张症的共存预示着哮喘和CRS方面更严重的疾病子集。我们建议，对于伴有NP、严重气流阻塞、嗜酸性粒细胞炎症和哮喘控制不良的哮喘CRS患者，应接受HRCT检查以早期诊断支气管扩张。
As a typical “united airway” disease, asthma-chronic rhinosinusitis (CRS) overlap has recently drawn more attention. Bronchiectasis is a heterogeneous disease related to a variety of diseases. Whether bronchiectasis exists and correlates with asthma-CRS patients has not been fully elucidated. The purpose of the study was to explore the presence and characteristics of bronchiectasis in patients with overlapping asthma and CRS. This report describes a prospective study with consecutive asthma-CRS patients. The diagnosis and severity of bronchiectasis were obtained by thorax high-resolution computed tomography (HRCT), the Smith radiology scale and the Bhalla scoring system. CRS severity was evaluated by paranasal sinus CT and the Lund-Mackay (LM) scoring system. The correlations between bronchiectasis and clinical data, fraction of exhaled nitric oxide, peripheral blood eosinophil counts and lung function were analyzed. Seventy-two (40.91%) of 176 asthma-CRS patients were diagnosed with bronchiectasis. Asthma-CRS patients with overlapping bronchiectasis had a higher incidence rate of nasal polyps (NPs) (P = 0.004), higher LM scores (P = 0.044), higher proportion of ≥ 1 severe exacerbation of asthma in the last 12 months (P = 0.003), lower postbronchodilator forced expiratory volume in one second (FEV1) % predicted (P = 0.006), and elevated peripheral blood eosinophil counts (P = 0.022). Smith and Bhalla scores were shown to correlate positively with NPs and negatively with FEV1% predicted and body mass index. Cutoff values of FEV1% predicted ≤ 71.40%, peripheral blood eosinophil counts > 0.60 × 109/L, presence of NPs, and ≥ 1 severe exacerbation of asthma in the last 12 months were shown to differentiate bronchiectasis in asthma-CRS patients. Bronchiectasis commonly overlaps in asthma-CRS patients. The coexistence of bronchiectasis predicts a more severe disease subset in terms of asthma and CRS. We suggest that asthma-CRS patients with NPs, severe airflow obstruction, eosinophilic inflammation, and poor asthma control should receive HRCT for the early diagnosis of bronchiectasis.
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影响因子：
2.5
作者：
Chen, Feng-Jia;Liao, Huai;Xie, Can-Mao
通讯作者：
Xie, Can-Mao
影响因子：
5.9
作者：
Coman, Isabel;Pola-Bibian, Beatriz;Quirce, Santiago
通讯作者：
Quirce, Santiago
影响因子：
3.7
作者：
Crimi, Claudia;Ferri, Sebastian;Crimi, Nunzio
通讯作者：
Crimi, Nunzio
影响因子：
5.8
作者：
Padilla-Galo, A.;Olveira, C.;Martinez-Garcia, M. A.
通讯作者：
Martinez-Garcia, M. A.
DOI：
10.1164/rccm.200406-710st
发表时间：
2005-04-15
影响因子：
24.7
作者：
American Thoracic Society;European Respiratory Society
通讯作者：
European Respiratory Society