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喫煙者における中央呼吸道崩壊と呼吸道の結果との関連
Surya P Bhatt1, Nina L J Terry2, Hrudaya Nath2
1Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham2UAB Lung Health Center, University of Alabama at Birmingham3UAB Lung Imaging Core, University of Alabama at Birmingham.
JAMA
|February 3, 2016
まとめ
喫煙者の中央呼吸道崩壊 (ECAC) は,呼吸器の生活の質の低下と悪化に関連しています. この発見は,喫煙者の呼吸器の健康に重要な要因としてECACを強調しています.
科学分野:
- 肺医学
- 放射線科
- 呼吸器の健康
背景:
- 呼気中枢呼吸道崩壊 (ECAC) は,吐出時に気管の光面の>50%の減少と定義され,喫煙とCOPDに関連しています.
- ECACの罹患率と臨床的意義はほとんど不明である.
研究 の 目的:
- 根底にある肺疾患とは無関係に,ECACと喫煙者の呼吸器疾患との関連を調査する.
- 人生の質,呼吸不全,運動能力,発症頻度に対するECACの影響を決定する.
主な方法:
- COPDGene研究 (8820人の現在の喫煙者/元喫煙者) のペア化された吸気-吸気CTスキャンの分析.
- トラキア直径の30%以上の減少を定量的にスクリーニングし,ECAC (>50%の面積減少) を確認するために手動で測定する.
- 呼吸器質の基準値 (SGRQ),呼吸不全 (mMRC),歩行距離6分,および経路悪化の頻度に関する評価
主要な成果:
- ECACは参加者の5%に存在しました.
- ECACはCOPDとは関係なく,呼吸器質の低下 (SGRQスコア) と呼吸不全の増加 (mMRCスコア) と有意に関連していました.
- ECAC患者では,全身重症や重症で入院が必要になる頻度が高い.
結論:
- ECACは喫煙者によく見られる症状で,呼吸器の生活の質の低下と関連しています.
- 喫煙者における呼吸器疾患の悪化などに ECAC が寄与することを示唆している.
- ECACの長期的な臨床的影響を完全に解明するには,さらなる研究が必要である.
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