Respiratory Research | |
Clinical and computed tomographic predictors of chronic bronchitis in COPD: a cross sectional analysis of the COPDGene study | |
Gerard J Criner1  Barry J Make2  James D Crapo2  Edwin K Silverman6  Jin Hwa Lee3  David Lynch2  Carlos H Martinez7  George Washko6  Meilan K Han7  Alejandro P Comellas5  Adam Davey4  Victor Kim1  | |
[1] Temple University School of Medicine, 785 Parkinson Pavilion, 3401 North Broad Street, Philadelphia, Pennsylvania 19140, USA;National Jewish Health, Denver, CO, USA;Ewha Womans University, Seoul, Korea;Department of Public Health, Temple University, Philadelphia, PA, USA;University of Iowa Hospital and Clinics, Iowa City, IA, USA;Brigham and Women’s Hospital, Boston, MA, USA;University of Michigan, Ann Arbor, MI, USA | |
关键词: Asthma; Airway thickening; Chronic obstructive pulmonary disease; Chronic bronchitis; | |
Others : 790291 DOI : 10.1186/1465-9921-15-52 |
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received in 2014-01-14, accepted in 2014-04-22, 发布年份 2014 | |
【 摘 要 】
Background
Chronic bronchitis (CB) has been related to poor outcomes in Chronic Obstructive Pulmonary Disease (COPD). From a clinical standpoint, we have shown that subjects with CB in a group with moderate to severe airflow obstruction were younger, more likely to be current smokers, male, Caucasian, had worse health related quality of life, more dyspnea, and increased exacerbation history compared to those without CB. We sought to further refine our clinical characterization of chronic bronchitics in a larger cohort and analyze the CT correlates of CB in COPD subjects. We hypothesized that COPD patients with CB would have thicker airways and a greater history of smoking, acute bronchitis, allergic rhinitis, and occupational exposures compared to those without CB.
Methods
We divided 2703 GOLD 1–4 subjects in the Genetic Epidemiology of COPD (COPDGene®) Study into two groups based on symptoms: chronic bronchitis (CB+, n = 663, 24.5%) and no chronic bronchitis (CB-, n = 2040, 75.5%). Subjects underwent extensive clinical characterization, and quantitative CT analysis to calculate mean wall area percent (WA%) of 6 segmental airways was performed using VIDA PW2 (http://www.vidadiagnostics.com webcite). Square roots of the wall areas of bronchi with internal perimeters 10 mm and 15 mm (Pi10 and Pi15, respectively), % emphysema, %gas trapping, were calculated using 3D Slicer (http://www.slicer.org webcite).
Results
There were no differences in % emphysema (11.4 ± 12.0 vs. 12.0 ± 12.6%, p = 0.347) or % gas trapping (35.3 ± 21.2 vs. 36.3 ± 20.6%, p = 0.272) between groups. Mean segmental WA% (63.0 ± 3.2 vs. 62.0 ± 3.1%, p < 0.0001), Pi10 (3.72 ± 0.15 vs. 3.69 ± 0.14 mm, p < 0.0001), and Pi15 (5.24 ± 0.22 vs. 5.17 ± 0.20, p < 0.0001) were greater in the CB + group. Greater percentages of gastroesophageal reflux, allergic rhinitis, histories of asthma and acute bronchitis, exposures to dusts and occupational exposures, and current smokers were seen in the CB + group. In multivariate binomial logistic regression, male gender, Caucasian race, a lower FEV1%, allergic rhinitis, history of acute bronchitis, current smoking, and increased airway wall thickness increased odds for having CB.
Conclusions
Histories of asthma, allergic rhinitis, acute bronchitis, current smoking, a lower FEV1%, Caucasian race, male gender, and increased airway wall thickness are associated with CB. These data provide clinical and radiologic correlations to the clinical phenotype of CB.
【 授权许可】
2014 Kim et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
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20140704232513748.pdf | 436KB | download | |
Figure 3. | 25KB | Image | download |
Figure 2. | 34KB | Image | download |
Figure 1. | 52KB | Image | download |
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