我们可以使用肺功能值和呼吸系统症状来识别前慢性阻塞性肺病吗? 一个前性的,基于人口的队列研究
Daniel J Tan1,2, Caroline J Lodge1, E Haydn Walters1,3
1Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
American journal of respiratory and critical care medicine
|January 18, 2024
概括
识别患有慢性阻塞性肺病 (COPD) 的高风险个体至关重要. 支气管扩展前FEV1/FVCz-score低于-1.264准确预测成人慢性肺炎的发展.
科学领域:
- 肺部病理学 肺部病理学
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 慢性阻塞性肺病前期 (COPD前期) 识别了没有空气流阻塞的COPD高风险个体.
- 目前用于识别COPD前的方法需要改进,特别是在年轻人群中.
研究的目的:
- 建立肺功能值和症状标准,以识别患有慢性肺炎风险的个体.
- 为了评估前支气管扩展器螺旋计对COPD发病率的预测准确度.
主要方法:
- 利用了塔斯马尼亚纵向健康研究的数据,这是一个基于人口的队列.
- 在45岁时评估呼吸道症状,支气管扩展前后的螺旋计,扩散能力和静态肺体积.
- 用全球肺功能倡议参考和优登指数来确定最佳门歧视的53岁的COPD发病率.
主要成果:
- 支气管扩张前FEV1/FVCz-score低于-1.264 (10百分位数) 是预测COPD发病率的最佳值.
- 低于这一门的人在8年内患上COPD的风险增加了36倍 (RR 35.8).
- 支气管前扩展剂FEV1/FVC单独提供了准确的分类,灵敏度为88%和特异性为87%.
结论:
- 这项研究首次评估了中年成年人中COPD发病率的螺旋计,扩散能力和肺体积值.
- 这些发现支持将支气管扩展前的螺旋计纳入COPD前的生理定义.
- 在第10个百分点的支气管扩展前FEV1/FVC有效地识别了在社区环境中患有COPD高风险的个人.
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