支气管扩张与肺功能丧失、医疗资源的大量使用以及心肺疾病患者的发病率和死亡率增加有关。我们评估了低剂量计算机断层扫描 (CT) 筛查计划参与者中支气管扩张的进展频率或新发展以及进展的预测因子。我们回顾了早期肺和心脏行动计划吸烟者队列中前瞻性入组的筛查队列，年龄为 40 岁2010 年至 2019 年间的 90 名患者，以及用于评估基线低剂量 CT 随访五年或更长时间后支气管扩张进展情况的医疗记录。使用逻辑和多变量协方差分析回归分析来检查与支气管扩张进展相关的因素。在 2182 名基线筛查参与者中，我们确定了 534 名参与者（平均年龄：65±9 岁；53.6% 女性），并进行了 5 名后续筛查年（中位随访时间：103.2 个月）。在 534 名参与者中，34 名（6.4%）参与者出现了支气管扩张（25/126，19.8%）或新出现（9/408，2.2%）支气管扩张。进展的重要预测因子（新开发的进展）是：年龄（P = 0.03），吸烟包年数（P = 0.004），ELCAP支气管扩张评分的基线组成部分，包括支气管扩张的严重程度（P = 0.01），其程度（P=0.01）、支气管壁增厚（P=0.04）和粘液嵌塞（P<0.001）。假设进展率相似，2182 名参与者中约有 136 名预计会在后续筛查中取得进展。这项研究揭示了低剂量 CT 筛查计划中支气管扩张的进展及其重要预测因素。我们建议报告支气管扩张，因为吸烟的参与者面临更高的风险，并且在参与低剂量 CT 筛查计划的整个期间进行持续评估将有助于识别可能的原因、早期预警，甚至早期治疗。版权所有 © 2024 Wolters Kluwer Health, Inc. 保留所有权利。

Bronchiectasis is associated with loss of lung function, substantial use of health care resources, and increased morbidity and mortality in people with cardiopulmonary diseases. We assessed the frequency of progression or new development of bronchiectasis and predictors of progression in participants in low-dose computed tomography (CT) screening programs.We reviewed our prospectively enrolled screening cohort in the Early Lung and Cardiac Action Program cohort of smokers, aged 40 to 90, between 2010 and 2019, and medical records to assess the progression of bronchiectasis after five or more years of follow-up after baseline low-dose CT. Logistic and multivariate-analysis-of-covariance regression analyses were used to examine factors associated with bronchiectasis progression.Among 2182 baseline screening participants, we identified 534 (mean age: 65±9 y; 53.6% women) with follow-up screening of 5+ years (median follow-up: 103.2 mo). Of the 534 participants, 34 (6.4%) participants had progressed (25/126, 19.8%) or newly developed (9/408, 2.2%) bronchiectasis. Significant predictors of progression (progressed+newly developed) were: age (P=0.03), pack-years of smoking (P=0.004), baseline components of the ELCAP Bronchiectasis Score, including the severity of bronchial dilatation (P=0.01), its extent (P=0.01), bronchial wall thickening (P=0.04), and mucoid impaction (P<0.001).Assuming similar progression rates, ~136 out of 2182 participants are expected to progress on follow-up screening. This study sheds light on bronchiectasis progression and its significant predictors in a low-dose CT screening program. We recommend reporting bronchiectasis as participants who have smoked are at increased risk, and continued assessment over the entire period of participation in the low-dose CT screening program would allow for the identification of possible causes, early warning, and even early treatment.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.