慢性阻塞性肺疾病与支气管扩张并存的相关因素研究

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1、授予单位代码10089m学号或申请号13470对於(£科ktHebeiMedicalUniversity硕士学位论文在职科学学位慢性阻塞性肺疾病与支气管扩张并存的相关因素研究学位申请人：赵京梅导师：阎锡新教授专业：内科学二级学院：第二医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师（或指导小组）的指导下，由本人独立完成。本学位论文研究所获的研究成果，其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公幵和使用。凡发表与学位论文相关的论文，第一署名单位为河北医科大学，试验材料、原始数据、申报的专利等知识产权均归河北

2、医科大学所有。否则，承担相应的法律责任。河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注和致谢等内容外，文中不包含其他人己经发表或撰写的研究成果，指导老师对此进行了审定。本论文由本人独立撰写，文责自负。研宂生签名:导师签章目录中文摘要·············································································1英文摘要·······················································

3、······················3英文缩写·············································································6研究论文慢性阻塞性肺疾病与支气管扩张并存的相关因素研究前言·············································································7资料与方法···································································

4、·7结果·············································································9附表·············································································11讨论·············································································13结论······································

5、·······································18参考文献·······································································18综述慢性阻塞性肺疾病与支气管扩张症并存的相关性研究·············23致谢···················································································37个人简历···································

6、··········································38中文摘要慢性阻塞性肺疾病与支气管扩张并存的相关因素研究摘要传统认为慢性阻塞性肺疾病（COPD）和支气管扩张症是两种不同的疾病。随着高分辨肺CT的广泛使用，我们观察到在临床患者中两者既可单独发生，又可以并存。在2014年COPD全球防治倡议（GOLD）中，把COPD与支气管扩张并存患者作为一种独特的表型对待，并指出其预后较差，且与潜在的病原微生物慢性感染或细菌定值以及频繁急性加重有关。本课题结合多中心慢性阻塞性肺疾病急性加重期（AECOPD）住院患者的病例分析，列举了慢性阻塞性

7、肺疾病与支气管扩张症并存患者的诸多临床特征。目的：本研究的目的是通过高分辨率计算机断层扫描（HRCT）发现中度和重度慢性阻塞性肺疾病患者合并支气管扩张症的患病率，并探讨该患病率与患者气道阻塞严重程度，疾病频繁加重、下呼吸道细菌定植的关系。方法：本研究自2014年1月至2015年1月，在河北医科大学第二医院、邯郸市中心医院收集了符合中度（50%≤FEV1<80%预计值，有或无慢性咳嗽、咳痰症状）或重度（30%≤FEV1<50%预计值，有或无慢性咳嗽、咳痰症状）慢性阻塞性肺疾病急性加重期（AECOPD）住院患者200例。这些患者除外肝脏、肾脏、消化系统疾病及结核、恶

8、性肿瘤、甲状腺功能亢进等