NGHIÊN CỨU MỐI LIÊN QUAN GIỮA ĐẶC ĐIỂM LÂM SÀNG VÀ HÌNH ẢNH CẮT LỚP VI TÍNH LỒNG NGỰC ĐA DÃY Ở BỆNH NHÂN GIÃN PHẾ QUẢN DO VIÊM PHẾ QUẢN MẠN

Abstract

Objectives: To describe the clinical and computed tomography characteristics, and to investigate the association between clinical features and chest CT findings in patients with bronchiectasis secondary to chronic bronchitis. Methods: A cross-sectional descriptive study was conducted on 120 patients diagnosed with chronic bronchitis and confirmed bronchiectasis on chest CT at Can Tho Central General Hospital between July 2024 and May 2026. Results: The median age was 73.5 years (IQR: 65.25-82), and 51.7% of patients were female. Fifty-five percent had a smoking history, with a median of 13 pack-years. Chronic cough and sputum production were present in all patients (100%), and crackles were the most common physical finding (56.7%). On CT, the signet-ring sign was present in 100% of patients and the tram-track sign in 89.2%; most cases showed mild bronchiectasis (75%), with the cylindrical type predominating (75.8%). Disease duration was significantly associated with the severity of bronchiectasis (p<0.001). Smoking status alone was not significantly associated with severity (p=0.525), whereas pack-years among smokers showed a strong dose-dependent association with severity (p<0.001). On multivariable analysis, bronchial wall thickening (OR=5.76; 95% CI: 2.12-15.61) and pulmonary consolidation (OR=4.96; 95% CI: 1.29-19.08) were independently associated with crackles, while emphysema was the strongest independent predictor of dyspnea (OR=15.58; 95% CI: 4.95-49.06). Conclusions: Bronchiectasis secondary to chronic bronchitis predominantly affects older adults, most commonly presenting with mild severity and cylindrical morphology. Disease duration and cumulative smoking exposure were closely associated with radiological severity. Bronchial wall thickening and pulmonary consolidation were independent CT correlates of crackles, while emphysema was the strongest independent correlate of dyspnea.