安定慢性閉塞性肺疾患患者における大気質警報ベース介入の効果評価:前向き無作為化比較試験
Xiaohua Zhang1, Shasha Xie1, Xueshuai Cao1
1Department of General Medicine, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China; Center for Community-Based Health Research, Fudan University, Shanghai, China.
Background:
Air pollution is a key modifiable trigger of acute exacerbations of chronic obstructive pulmonary disease (AECOPD), but the efficacy of real-time air quality alert interventions for community-dwelling stable COPD patients remains unvalidated.
Methods:
This prospective stratified randomized controlled trial (RCT) enrolled 255 stable COPD patients from 3 Shanghai community health centers, randomly assigned (1:1:1) to Control (routine management), Education (routine + pollution education), or Alert (routine + WeChat-based real-time AQI alerts) Groups. The primary outcome was 12-month AECOPD frequency. Secondary outcomes included pulmonary function, symptom scores (SGRQ/CAT/mMRC), and biomarkers. Analyses used negative binomial regression, nonparametric tests, and Generalized Estimating Equations (GEE) model.
Results:
226 patients (88.6% follow-up rate) completed the study. Compared to Control Group, Alert Group had 39.3% lower AECOPD risk (IRR=0.607, 95% CI:0.401-0.924); Education Group showed no significant reduction (IRR = 0.819, 95% CI: 0.543-1.236). Both intervention groups significantly improved SGRQ scores (Education: B = -7.192, 95% CI: -11.664, -2.720; Alert: B = -6.059, 95% CI: -10.518, -1.599). After GEE adjustment, only Alert Group had lower IL-8 (B=-0.950, 95% CI: -1.795, -0.104); pulmonary function was mostly unchanged, with no CD4+/CD8+ T-cell differences.
Conclusions:
WeChat-based air quality alerts reduced AECOPD risk and improved symptoms in stable COPD, outperforming pollution education, supporting digital environmental management in community COPD care.
関連する概念動画
Chronic Obstructive Pulmonary Disease
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
Chronic Obstructive Pulmonary Disease-I: Introduction
Chronic Obstructive Pulmonary Disease-V: Management
Smoking Cessation
Chronic Obstructive Pulmonary Disease-II: Pathophysiology
Chronic Inflammation
Chronic Obstructive Pulmonary Disease-V: Nursing Management
Assessment
Chronic Obstructive Pulmonary Disease-III: Symptoms and Complications.
Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD:


