遂宁地区慢性阻塞性肺疾病患者支气管扩张流行病学特征及危险因素  

Epidemiological characteristics and risk factors of bronchiectasis in patients with chronic obstructive pulmonary disease in Suining area

作　　者：龙瀛[1] 罗晓斌[1] 李蓉[1] 姚宇 胡建平[2] LONG Ying;LUO Xiaobin;LI Rong;YAO Yu;HU Jianping(Respiratory Department of Suining Central Hospital,Suining,Sichuan 629000,China;Department of Emergency,Suining Central Hospital,Suining,Sichuan 629000,China)

机构地区：[1]四川省遂宁市中心医院呼吸内科,四川遂宁629000 [2]四川省遂宁市中心医院急诊科,四川遂宁629000

出　　处：《公共卫生与预防医学》2023年第5期141-144,共4页Journal of Public Health and Preventive Medicine

摘　　要：目的 分析遂宁地区慢性阻塞性肺疾病(chronic obstructive pulmonary diseases, COPD)患者发生支气管扩张的流行病学特征及危险因素,为COPD防治支气管扩张提供理论依据。方法 选取2019—2020年遂宁地区三甲医院收治的COPD急性加重期(AECOPD)患者291例作为调查对象,根据患者是否发生支气管扩张分为对照组(不合并支气管扩张,n=242)和观察组(合并支气管扩张,n=49),比较两组年龄、性别、是否合并其他疾病、合并呼吸道感染、脓性痰比例、铜绿假单胞菌定植率等级等临床资料,采用单因素分析和logistic回归分析COPD患者发生支气管扩张的危险因素。结果 AECOPD患者发生支气管扩张占16.84%(49/291);观察组铜绿假单胞菌定植率均明显高于对照组(P<0.05);观察组FVC、FEV1/FVC值明显低于对照组(P<0.05);观察组血清CRP和PCT水平明显高于对照组(P<0.05);男性(OR=2.515)、GOLD分级III/IV级比例高(OR=3.654)、吸烟(OR=3.472)、糖尿病(OR=3.829)、细菌感染(OR=4.159)是COPD患者发生支气管扩张的独立危险因素(P<0.05)。结论 遂宁地区COPD患者发生支气管扩张的风险较高,其肺功能下降较为明显,且铜绿假单胞菌定植率较高。对于男性、GOLD分级III/IV级比例高、吸烟、糖尿病、细菌感染的患者,应给予干预措施,可降低COPD患者发生支气管扩张的风险。Objective To analyze the epidemiological characteristics and risk factors of bronchiectasis in patients with chronic obstructive pulmonary disease(COPD)in Suining area,and to provide theoretical basis for COPD prevention and treatment of bronchiectasis.Methods 291 patients with acute exacerbation of COPD(AECOPD)admitted to a tertiary hospital in Suining area from 2019 to 2020 were selected as the survey subjects.They were divided into a control group(without bronchiectasis,n=242)and an observation group(with bronchiectasis,n=49)based on whether the patients had bronchiectasis.Clinical data such as age,gender,presence of other diseases,presence of respiratory infections,proportion of purulent sputum,and level of Pseudomonas aeruginosa colonization rate were compared between the two groups,Single factor analysis and logistic regression were used to analyze the risk factors for bronchiectasis in COPD patients.Result The incidence of bronchiectasis in AECOPD patients was 16.84%(49/291).The colonization rate of Pseudomonas aeruginosa in observation group was significantly higher than that in control group(P<0.05).The values of FVC and FEV1/FVC in observation group were significantly lower than those in control group(P<0.05).The levels of serum CRP and PCT in the observation group were significantly higher than those in the control group(P<0.05).Male(OR=2.515),high proportion of GOLD grade III/IV(OR=3.654),smoking(OR=3.472),diabetes(OR=3.829)and bacterial infection(OR=4.159)were independent risk factors for bronchiectasis in COPD patients(P<0.05).Conclusion COPD patients in Suining area have a high risk of bronchiectasis.The lung function was declined significantly.It has a high colonization rate of Pseudomonas aeruginosa.Patients who are male,have a high proportion of GOLD class III/IV,smoke,have diabetes,and have bacterial infections should be given interventions that can reduce the risk of bronchiectasis in COPD patients.

关 键 词：慢性阻塞性肺疾病 支气管扩张 流行病学特征 

分 类 号：R181[医药卫生—流行病学]