慢性阻塞性肺病患者的呼吸道含粘液塞和死亡率
Alejandro A Diaz1,2, José L Orejas1,2, Scott Grumley3
1Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
JAMA
|May 21, 2023
概括
慢性阻塞性肺病患者的呼吸道粘液塞与死亡率的增加有关. 胸部CT扫描显示中大气道的粘液塞与COPD患者的死亡风险较高相关.
科学领域:
- 肺部医学
- 放射学
- 流行病学
背景情况:
- 慢性阻塞性肺病 (COPD) 中常见的是气道粘液堵塞.
- 呼吸道粘液堵塞在COPD患者中的预后意义尚不清楚.
研究的目的:
- 通过胸部计算机断层扫描 (CT) 发现的气道粘液塞与COPD患者的全因死亡率之间的关联.
主要方法:
- 从COPD队列的遗传流行病学中收集的前性数据的回顾性分析.
- 胸部CT扫描用于识别和量化中大气道中的粘液塞.
- 用调整的比例危险回归模型评估所有原因的死亡率.
主要成果:
- 在4363名COPD参与者中,59.3%没有粘液塞,21.8%有1-2段的塞,18.9%有3+段的塞.
- 在平均9. 5年的随访期内,死亡率分别为0. 1%,1. 2%,3+组.
- 在1-2段 (aHR,1.15) 和3+段 (aHR,1.24) 的粘液塞与调整后的死亡风险增加有关.
结论:
- 在COPD患者中存在阻塞中大气道的粘液塞与全因死亡率的增加有关.
- 胸部CT识别气道粘液堵塞可能作为COPD的预后标志物.
- 进一步的研究可以探索针对COPD的治疗策略.
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