临床重要恶化 (CID) 和COPD的衰老:根据PRISMA声明进行系统性审查和元回归分析
Gian Marco Manzetti1, Josuel Ora1, Arianna Sepiacci1
1Department of Experimental Medicine, Unit of Respiratory Medicine, University of Rome "Tor Vergata", Rome, Italy.
International journal of chronic obstructive pulmonary disease
|October 16, 2023
概括
衰老可能会增加慢性阻塞性肺病 (COPD) 患者临床重要恶化的风险,特别是那些肺功能减弱的患者. 吸入疗法仍然有效,但在老年人中可能提供较少的保护.
科学领域:
- 肺部病理学 肺部病理学
- 临床试验 临床试验
- 老年医学 老年医学
背景情况:
- 临床重要恶化 (CID) 是慢性阻塞性肺病 (COPD) 临床试验中使用的复合终点,具有预后价值.
- 慢性肺炎包括1秒内强迫呼吸量 (FEV1) 减少,圣乔治呼吸问卷 (SGRQ) 评分恶化,或中度至严重的恶化.
- 虽然COPD随着年龄的增长而恶化,但老龄化对CID风险的具体影响尚未得到充分研究.
研究的目的:
- 研究衰老对慢性阻塞性肺病 (COPD) 患者临床重要恶化的风险的影响.
主要方法:
- 我们对来自17项研究的55219名COPD患者的数据进行了元分析和元回归.
- 该分析量化了药物治疗对CID的影响,并评估了衰老是否会调节这种风险.
- 遵循了PRISMA-P的指导方针,并评估了偏差风险.
主要成果:
- 吸入治疗通常可以降低COPD患者的慢性发作风险 (RR:0.81,95% CI:0.79-0.84).
- 观察到年龄和CID风险之间的线性关系具有显著性的趋势 (P=0.063).
- 年龄在患有较低的支气管扩张后FEV1 (P<0.05) 患者中显著增加了CID风险.
结论:
- 吸入治疗有效降低了COPD患者的CID风险.
- 这种保护作用可能会在老年COPD患者中减弱,而COPD患者的肺功能受损.
- 需要进一步的专门针对COPD中CID的研究来证实这些发现.
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