308 Ch 307. Bronchiectasis

Bronchiectasis = 永久性、不可逆 bronchial dilation + 慢性 inflammation；分 CF (cystic fibrosis-related) vs non-CF；非 CF 原因多：post-infectious (childhood pneumonia, TB, NTM, pertussis)、immunodeficiency (CVID, hypogammaglobulinemia)、ABPA、autoimmune (RA, SLE, IBD)、α1-antitrypsin deficiency、primary ciliary dyskinesia (PCD, Kartagener)、young’s syndrome、connective tissue disease、aspiration；診斷靠 HRCT (signet ring sign, tram tracks, bronchial wall thickening, varicose / cystic / cylindrical patterns)；治療：airway clearance (physiotherapy, OPEP, hypertonic saline)、chronic antibiotics（azithromycin for frequent exacerbations）、treat underlying、inhaled antibiotics for Pseudomonas (tobramycin, colistin)、brensocatib (DPP-1 inhibitor) Phase 3 positive 2024 — 第一個專為 bronchiectasis 開發的 disease-modifying；NTM (Mycobacterium avium complex, MAC) 共病常見 — 加長療程 macrolide + ethambutol + rifamycin。