Phenotyping Adults with Non-Cystic Fibrosis Bronchiectasis: A 10-Year Cohort Study in a French Regional University Hospital Center
Phenotyping Adults with Non-Cystic Fibrosis Bronchiectasis: A 10-Year Cohort Study in a French Regional University Hospital Center
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DOI：
10.1159/000446923
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发表时间：
2016-01-01
期刊：
影响因子：
3.7
通讯作者：
Leroy, Sylvie
中科院分区：
文献类型：
--
作者：
Buscot, Matthieu;Pottier, Heloise;Leroy, Sylvie
背景：关于支气管扩张症表型的数据很少。目的：本研究的目的是描述支气管扩张症患者的临床、功能和微生物学表型。方法：在法国一所大学医院进行了一项为期10年（2002-2012年）的单中心回顾性研究。纳入了经断层扫描证实为支气管扩张的非囊性纤维化患者。根据潜在病因分析患者的临床、功能和微生物学数据。结果：在纳入的311例患者中，245例发现了病因。诊断时，中位年龄为61岁，平均FEV 1为预测值的63%。支气管扩张的主要原因是感染后（50%，大多与结核病有关）、慢性阻塞性肺疾病（COPD; 13%）和特发性（11%）。其他病因依次为免疫缺陷（6%）、哮喘（4%）、自身免疫（3%）、肿瘤（2%）和其他原因（4%）。表型特征的比较显示，COPD、先天性和特发性组在性别（p = 0.0175）、吸烟状况（p < 0.0001）、FEV 1（p = 0.0412）和诊断时年龄（p < 0.001）、铜绿假单胞菌（PA）定植（p = 0.0276）和肺叶切除术（0.0093）方面存在显著差异。30%的患者进行了功能随访，中位持续时间为2.7年。PA的存在与诊断时较低的FEV 1中位数相关（43% p < 0.003），但与FEV 1下降速度无关。结论：特发性、先天性和COPD相关性支气管扩张症具有不同的临床、功能和微生物学特征。有必要对这些亚组进行前瞻性随访，以验证其在管理细菌定植和这些支气管扩张症的特定并发症方面的相关性。(C)2016 S. Karger AG，巴塞尔
Background: Data concerning phenotypes in bronchiectasis are scarce. Objective: The aim of this study was to describe the clinical, functional and microbiological phenotypes of patients with bronchiectasis. Methods: A monocentric retrospective study in a university hospital in France was conducted over 10 years (2002-2012). Non-cystic fibrosis patients with tomographic confirmation of bronchiectasis were included. The clinical, functional and microbiological data of patients were analyzed relying on the underlying etiology. Results: Of the 311 included patients, an etiology was found for 245 of them. At the time of diagnosis, the median age was 61 years and the mean FEV1 was 63% of predicted. The main causes of bronchiectasis were post-infectious (50%, mostly related to tuberculosis), chronic obstructive pulmonary disease (COPD; 13%) and idiopathic (11%). Other causes were immune deficiency (6%), asthma (4%), autoimmunity (3%), tumor (2%) and other causes (4%). The comparison of phenotypic traits shows significant differences between COPD, congenital and idiopathic groups in term of sex (p = 0.0175), tobacco status (p < 0.0001), FEV1 (p = 0.0412) and age at diagnosis (p < 0.001), Pseudomonas aeruginosa (PA) colonization (p = 0.0276) and lobectomy (0.0093). Functional follow-up was available in 30% of patients with a median duration of 2.7 years. Presence of PA was associated with a lower median FEV1 at diagnosis (43% p < 0.003) but not with a faster rate of decline in FEV1. Conclusion: Distinctive clinical, functional and microbiological features were found for idiopathic, congenital and COPD-related bronchiectasis. A prospective follow-up of these subgroups is necessary to validate their relevance in the management of bacterial colonization and specific complications of these bronchiectases. (C) 2016 S. Karger AG, Basel