从COPD前期到COPD:一个简单,低成本,易于实施的风险计算器 (SLIM)
Miguel J Divo1, Congjian Liu2, Francesca Polverino3
1Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA mdivo@bwh.harvard.edu.
The European respiratory journal
|September 7, 2023
概括
识别患有慢性气流限制 (CAL) 的高风险吸烟者对于早期干预至关重要. 使用肺功能,吸烟史,BMI和支气管炎症状的简单模型准确地预测了常吸烟者的CAL发展.
科学领域:
- 肺部病理学 肺部病理学
- 呼吸系统医学 呼吸系统医学
- 流行病学 流行病学
背景情况:
- 慢性阻塞性肺病 (COPD) 影响了13-22%的吸烟者.
- 早期识别患有COPD风险的个体对于及时干预至关重要.
- 这项研究旨在确定常吸烟者慢性气流限制 (CAL) 的预测因素.
研究的目的:
- 开发和验证一次性吸烟者发生慢性气流限制 (CAL) 的预测模型.
- 确定与CAL发展相关的关键临床和生理变量.
- 为处于风险的个人提供早期干预策略.
主要方法:
- 分析了来自洛维莱斯吸烟者队列 (LSC) 的677名参与者,基线螺旋计正常,并至少进行了三次后续测量.
- 后勤回归用于识别基于人口统计,人类计量,吸烟史,症状和螺旋计的事件CAL的预测因素.
- 预测模型在COPDGene研究队列中的验证.
主要成果:
- 在6.3年的时间里,CAL的发病率为每1000人年26例.
- CAL的主要预测因素包括FEV1/FVC<0.75,吸烟≥30包年,BMI ≤25 kg/m2和慢性支气管炎症状.
- 结合这四个因素的模型预测了CAL的发展,在6年内有85%的风险 (AUC ROC 0.84).
- 该模型在COPDGene队列中表现良好 (AUC ROC 0.77).
结论:
- 结合FEV1/FVC,吸烟史,BMI和慢性支气管炎的简单预测模型有效地识别了中年常吸烟者,他们患CAL的风险很高.
- 这个模型可以帮助早期检测和干预那些容易患上COPD的个体.
- 这些发现支持使用随时可用的临床数据来对吸烟者的风险分层进行研究.
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