Study of the early diagnosis and treatment of bronchiectasis combined with chronic obstructive pulmonary disease

Abstract

Objective To assess the influence and early diagnosis treatment of bronchiectasis using severity score in patients with chronic obstructive pulmonary disease (COPD) combined with bronchiectasis. Methods Sixty patients with bronchiectasis in stable stage were selected from July 2016 to August 2017. The patients were divided into simple bronchiectasis group (32 cases) and bronchiectasis combined with COPD group (28 cases). The general clinical features, chest high-resolution CT (HRCT), pulmonary function, fractional exhaled nitric oxide (FENO) and bronchiectasis severity score between 2 groups were compared. The changes of the indexes 6 months after treatment with inhaled salmeterol fluticasone (50 μg/250 μg) in bronchiectasis combined with COPD group were observed. Results The bronchiectasis severity score and FENO in bronchiectasis combined with COPD group were significantly higher than those in simple bronchiectasis group: (4.82 ± 0.91) scores vs. (2.88 ± 0.83) scores and (39.04 ± 9.57) nmol/L vs. (28.66 ± 6.12) nmol/L, and there were statistical differences (P<0.01). The forced expired volume in one second as a percentage of expected value (FEV1%Pred) and forced vital capacity as a percentage of expected value (FVC%Pred) in bronchiectasis combined with COPD group were significantly lower than those in simple bronchiectasis group: (61.36 ± 5.23)% vs. (71.28 ± 6.67)% and (61.57 ± 7.60)% vs. (72.84 ± 7.19)%, and there were statistical differences (P<0.01). In bronchiectasis combined with COPD group, there were statistical differences in the bronchiectasis severity score, FEV1%Pred, FVC%Pred and FENO 6 months after treatment with inhaled salmeterol fluticasone and before treatment (P<0.05). There was a negative correlation between FEV1%Pred and bronchiectasis severity score before and after treatment (r=-0.802 and-0.618, P<0.05); and there was a positive correlation between the FENO and bronchiectasis severity score (r=0.728 and 0.586, P<0.05). Conclusions The pathogenetic condition of bronchiectasis combined with COPD is severe compared with simple bronchiectasis. Inhaled salmeterol fluticasone is effective in patients with bronchiectasis combined with COPD. Key words: Bronchiectasis; Pulmonary disease, chronic obstructive; Fractional exhaled nitric oxide; Bronchiectasis severity score