老年COPD合并支气管扩张的危险因素分析

目的探讨老年慢性阻塞性肺疾病(COPD)合并支气管扩张的危险因素。 方法回顾性分析2015年6月至2018年6月我院收治的153例COPD患者病例资料。按照是否合并支气管扩张，将患者分为单纯COPD组(n＝96)和合并支气管扩张组(n＝57)。比较两组患者的一般资料、临床症状、血常规指标及红细胞沉降率(ESR)、血气分析检测指标，分析患者痰标本中细菌组成，合并支气管扩张的危险因素。 结果单纯COPD组与合并支气管扩张组患者性别、年龄、吸烟史、肺结核史及住院时间相比有明显差异(P<0.05)；合并支气管扩张患者症状持续时间及伴脓痰症状人数明显高于单纯COPD组(P<0.05)；单纯COPD组患者血清中血红蛋白(Hb)水平明显高于合并支气管扩张组患者，C反应蛋白(CRP)及ESR明显低于合并支气管扩张组患者(P<0.05)；合并支气管扩张组患者二氧化碳分压(PaCO₂)水平明显高于单纯COPD组患者(P<0.05)；合并支气管扩张组患者痰涂片铜绿假单胞菌感染例数明显高于单纯COPD组患者(P<0.05)；COPD患者中，女性、有肺结核史、痰涂片有铜绿假单胞菌感染、伴脓痰症状、症状持续时间长及住院时间长是合并支气管扩张的危险因素(P<0.05)。 结论女性、住院时间长、肺结核史、痰涂片铜绿假单胞菌感染、伴脓痰症状、症状持续时间长及住院时间长的COPD患者更易患支气管扩张，是老年COPD患者合并支气管扩张的危险因素。

Analysis of risk factors for elderly patients with chronic obstructive pulmonary disease complicated with bronchiectasis

ObjectiveTo investigate the risk factors for elderly patients with chronic obstructive pulmonary disease (COPD) complicated with bronchiectasis. MethodsRetrospective analysis was performed on the data of 153 patients with COPD who were admitted to our hospital from June 2015 to June 2018. The patients were divided into a COPD group (n=96) and a combined bronchiectasis group (n=57) according to the presence or absence of bronchiectasis. The general data, clinical symptoms, blood routine indicators and erythrocyte sedimentation rate (ESR), as well as the blood gas analysis indicators of the patients were compared between the two groups. The bacterial composition in the sputum specimens and the influencing factors of bronchiectasis were analyzed. ResultsThe gender, age, smoking history, tuberculosis history and hospital stay had statistical differences between the COPD group and the combined bronchiectasis group (P<0.05). The duration of symptoms and the number of patients with purulent symptoms in the combined bronchiectasis group were significantly higher than those of the COPD group (P<0.05). The patients in the COPD group had higher serum levels of hemoglobin (Hb) as well as lower levels of C-reactive protein (CRP), ESR and the partial pressure of carbon dioxide (PaCO₂) than those of the combined bronchiectasis group (P<0.05). The incidence of Pseudomonas aeruginosa infection in the sputum smears of the combined bronchiectasis group was higher than that of the COPD group (P<0.05). Therefore, among the elderly patients with COPD, females or the patients who had a tuberculosis history, Pseudomonas aeruginosa infection, purulent sputum symptoms, long duration of symptoms or long hospitalization were easy to suffer from bronchiectasis (P<0.05). ConclusionFemale, long hospitalization time, history of tuberculosis, pseudomonas aeruginosa infection, purulent sputum symptoms, long duration of symptoms and long hospitalization time are risk factors for bronchiectasis in the elderly patients with COPD.