Suspecting non-cystic fibrosis bronchiectasis: What the busy primary care clinician needs to know.
Suspecting non-cystic fibrosis bronchiectasis: What the busy primary care clinician needs to know.
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DOI：
10.1111/ijcp.12924
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发表时间：
2017-02
影响因子：
2.6
通讯作者：
Diaz AA
中科院分区：
文献类型：
--
作者：
Maselli DJ;Amalakuhan B;Keyt H;Diaz AA
非囊性纤维化支气管扩张症（NCFB）是一种慢性、进行性呼吸系统疾病，其特征为不可逆和异常的气道扩张、持续咳嗽、痰量过多和复发性肺部感染。在过去的几十年里，它的患病率有所增加，使其有可能在初级保健环境中遇到。目的是回顾NCFB的临床表现和诊断，重点是计算机断层扫描（CT）的作用。在本综述中，试验和报告来自PubMed/Medline和美国NIH的ClinicalTrials.gov以及对照试验的科克伦注册中心。检索使用关键词：支气管扩张、非囊性纤维化支气管扩张、慢性肺部感染和计算机断层扫描。没有使用日期/语言限制。非囊性纤维化支气管扩张症通常与其他呼吸系统疾病共存，如慢性阻塞性肺疾病。NCFB的患病率正在增加，特别是在妇女和老年人中，这可能是由于医生意识的提高和CT的广泛使用，CT是诊断NCFB的金标准。CT可以帮助确定NCFB的根本原因，并确定疾病的范围和严重程度。对于慢性咳嗽、脓痰和频繁呼吸道感染的患者，应在初级保健环境中怀疑非囊性纤维化支气管扩张，这些患者往往会缓慢或部分消退。通过CT和其他检查早期诊断和确定疾病的范围和严重程度对于建立治疗以改善NCFB患者的生活质量和潜在地减缓肺功能的进行性下降至关重要。
Non‐cystic fibrosis bronchiectasis (NCFB) is a chronic, progressive respiratory disorder characterised by irreversibly and abnormally dilated airways, persistent cough, excessive sputum production and recurrent pulmonary infections. In the last several decades, its prevalence has increased, making it likely to be encountered in the primary care setting. The aim was to review the clinical presentation and diagnosis of NCFB, with an emphasis on the role of computed tomography (CT). For this review, trials and reports were identified from PubMed/Medline and ClinicalTrials.gov from the US NIH and the Cochrane Register of Controlled Trials. The search used keywords: bronchiectasis, non‐cystic fibrosis bronchiectasis, chronic pulmonary infection and computed tomography. No date/language restrictions were used. Non‐cystic fibrosis bronchiectasis often coexists with other respiratory conditions, such as chronic obstructive pulmonary disease. The prevalence of NCFB is increasing, particularly in women and older individuals, possibly as a result of increased physician awareness and widespread use of CT, which is the gold standard for the diagnosis of NCFB. CT can assist in identifying an underlying cause of NCFB and determining the extent and severity of the disease. Non‐cystic fibrosis bronchiectasis should be suspected in the primary care setting in patients with chronic cough, purulent sputum and frequent respiratory infections that tend to resolve slowly or partially. Early diagnosis and determination of the extent and severity of the disease by CT and other tests are critical to establish therapy to improve quality of life and potentially slow progressive decline of lung function in patients with NCFB .