Abstract:
Objective To explore the relevant factors affecting pulmonary function in patients with bronchiectasis.
Methods The patients diagnosed with bronchiectasis in Zhongshan Hospital, Fudan University from January 1, 2017 to December 31, 2019 were selected. Baseline data including demographic information, medical history, clinical manifestations, laboratory indicators, pulmonary function (spirometry and diffusing capacity), chest high-resolution computed tomography (HRCT), and treatment information. Patients were divided into different groups according to different grades of the percentage of predicted value of forced expiratory volume in one second (FEV1%pred) and the percentage of predicted value of diffusion capacity for carbon monoxide of lung (DLCO%pred), and the clinical characteristics, laboratory indicators were compared among the different groups. Logistic regression analysis was used to analyze the related factors affecting pulmonary function.
Results 160 patients were included. There were statistically significant differences in the number of acute exacerbations past 1 year, number of involved lung lobes on CT images, Reiff score, clinical symptoms, positive proportion of Pseudomonas aeruginosa in sputum culture, 24-hour sputum volume, and white blood cell count in patients with different FEV1%pred or DLCO%pred grades (P<0.05). Multivariate logistic regression analysis showed that higher COPD assessment test (CAT score; OR=1.170, 95%CI 1.059-1.293, P<0.01), higher Reiff score (OR=1.541, 95%CI 1.236-1.920, P<0.01), Pseudomonas aeruginosa positive (OR=8.166, 95%CI 1.727-38.623, P<0.01) and disease duration≥10 years (OR=4.933, 95%CI 1.371-17.753, P<0.05) were independent risk factors of FEV1%pred<50%; higher CAT score (OR=1.083, 95%CI 1.003-1.169, P<0.05) and the number of lobe involved on CT images≥3 (OR=3.914, 95%CI 1.316-11.646, P<0.05) were independent risk factors of DLCO%pred<80%.
Conclusion The longer disease duration, higher Reiff score, more lobes involved, the more severe the pulmonary function damage in bronchiectasis patients.