在有吸烟史,肺功能正常和受损的成年人中怀疑支气管切除和死亡率:一项队列研究
Alejandro A Diaz1, Wei Wang2, Jose L Orejas1
1Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts (A.A.D., J.L.O., R.E., W.R.D., B.C., C.L.P.).
Annals of internal medicine
|October 2, 2023
概括
通过CT扫描和症状识别的可疑支气管切除,增加了正常或阻塞性螺旋计吸烟者的死亡风险. 这一发现凸显了风险人群早期检测的重要性.
科学领域:
- 肺部医学 肺部医学
- 放射学 放射学是一门学科.
- 流行病学 流行病学
背景情况:
- 慢性肺炎患者的支气管切除与较高的死亡率有关.
- 在吸烟者中,可疑的支气管切除症对正常或受损的螺旋计的死亡率的影响尚不清楚.
研究的目的:
- 调查疑似支气管切除症与成年人的死亡率之间的关联,使用正常的螺旋计,保留比率受损螺旋计 (PRISm) 和阻塞性螺旋计.
主要方法:
- 从COPDGene研究中对7662名成年人的前性观察队列研究.
- 支气管切除症在CT扫描上使用基于AI的气道与动脉比率 (AAR>1) 进行鉴定.
- 疑似支气管切除症需要AAR>1加上两个临床症状 (咳,,呼吸障碍,恶化).
主要成果:
- 17.6%的参与者怀疑有支气管切除症.
- 在11年内,所有螺旋计组中,疑似支气管切除症患者的死亡率更高.
- 在正常螺旋计 (15%) 和阻塞螺旋计 (6%) 组中,十年死亡风险显著增加.
结论:
- 疑似支气管切除与正常和阻塞性螺旋计成年人死亡风险增加有关.
- 这项研究强调了吸烟者偶发支气管切除症发现的临床意义.
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