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High prevalence of bronchiectasis in emphysema-predominant COPD patients

Shuang Dou, Chunyan Zheng, Liwei Cui, et al.
Int J Chron Obstruct Pulmon Dis 2018;13:2041–47
doi: 10.2147/COPD.S163243

The 2017 update of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) has emphasised the impact that bronchiectasis has on the course and prognosis of chronic obstructive pulmonary disease (COPD). Studies on co-existing COPD and bronchiectasis have focused on the influence of co-existing diseases on acute exacerbation frequency, severity of airflow limitation, prognosis and the characteristics of pathogenic microorganisms. However, little is known about the relationship between bronchiectasis and different phenotypes of COPD subjects. Should bronchiectasis, like emphysema and chronic bronchitis, be considered a phenotype of COPD?

In this retrospective study of 1739 COPD patients, the prevalence of bronchiectasis in different phenotypes of COPD subjects and the correlation between bronchiectasis and different phenotypes, especially emphysema, were investigated.

The COPD patients were divided into two groups: those with bronchiectasis (n=140) and those without (n=1599). Those with both COPD and bronchiectasis had worse states of nutrition, more severe airway obstruction and more extensive emphysema than those patients without bronchiectasis.

Comparing emphysema-predominant and non-emphysema-predominant groups, the former had a higher proportion of bronchiectasis, higher emphysema index (EI) and more severe airway limitations.

This study represented the first time that EI was used to explore the correlation between bronchiectasis and different phenotypes in COPD patients. The study’s comparison of COPD patients with and without bronchiectasis implies that exploring the mechanisms of co-existing COPD and bronchiectasis may help clinicians to better understand the pathology and pathophysiology of COPD.

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