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探索GOLD 2023指南的有效性:GOLD C和D应该结合在一起吗?

Christopher Duckworth¹, Michael J Boniface¹, Adam Kirk²

¹IT Innovation Centre, Digital Health and Biomedical Engineering, University of Southampton, Southampton, UK.

International journal of chronic obstructive pulmonary disease

|October 31, 2023

概括

全球慢性阻塞性肺病倡议 (GOLD) 2023年指导方针合并了高风险的COPD类别C和D. 这项研究发现,这些组之间的症状得分和恶化率显著不同,这表明应该重新考虑合并.

科学领域:

肺部医学肺部医学
数字健康数字健康
临床指南临床指南

背景情况:

全球慢性阻塞性肺病倡议 (GOLD) 2023年指导方针修订了COPD分层,将GOLD C和D合并为一个新的E类别,仅基于恶化史.
这一变化忽略了症状学 (例如,COPD评估测试得分) 在区分高风险患者群体.

研究的目的:

通过评估使用GOLD 2022 ABCD方案分层的个体的疾病进展来评估GOLD 2023指南变化的影响.
为了确定在建议的指导方针变化后,GOLD C和D组之间的症状严重程度和恶化率是否仍然存在区别.

主要方法:

利用了myCOPD移动应用程序的1529名用户的数据,这是英国COPD管理的验证工具.
使用COPD评估测试 (CAT) 分数和12个月期间恶化率量化症状严重程度,最初被分为GOLD B,C和D组的患者.

主要成果:

12个月后,GOLD C和D用户之间的CAT分数仍然存在显著差异 (P = 8.2 × 10-23).
在12个月的时间里,GOLD C用户的恶化率明显低于GOLD D用户 (P = 3.1 × 10-2).
与GOLD C用户相比,GOLD B用户在随后的12个月中显示出更高的CAT得分和恶化率.

结论:

慢性肺炎评估测试 (CAT) 的得分仍然对分层疾病进展至关重要,反映了症状和未来恶化风险.
在GOLD 2023指南中,GOLD C和D类别的拟议合并值得重新考虑,因为疾病进展标志物的持续显著差异.

关键词:

全球慢性阻塞性肺病全球倡议不同的疾病进展.恶化的速度加剧.

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