支气管病与慢性阻塞性肺病之间的关联:来自欧洲支气管病登记处 (EMBARC) 的数据
Eva Polverino1,2, Anthony De Soyza3, Katerina Dimakou4
1Pneumology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Vall d'Hebron Barcelona Hospital Campus, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Barcelona, Spain.
American journal of respiratory and critical care medicine
|January 25, 2024
概括
许多患有支气管切除症的患者被错误地诊断为慢性阻塞性肺病 (COPD). 应用客观标准表明,很大一部分人缺乏COPD关键指标,影响临床结果和疾病管理.
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
- 临床流行病学 临床流行病学
背景情况:
- 慢性阻塞性肺病 (COPD) 和支气管切除症经常同时存在.
- 诊断标准的差异影响了对它们对患者结果的综合影响的理解.
- 需要客观的定义来澄清这些条件之间的关联.
研究的目的:
- 为了确定慢性阻塞性肺病 (COPD) 患有支气管病的患者的患病率.
- 评估这种联合诊断与临床结果之间的关系.
- 评估标准化ROSE标准对客观定义COPD在支气管切除症患者中的有用性.
主要方法:
- 分析了来自欧洲支气管病例登记 (EMBARC) 的数据,这是一项前性观察性研究.
- 包括来自28个国家的16730名计算机断层扫描确认的支气管切除症患者.
- 应用ROSE标准 (放射性支气管炎症,阻塞,症状,暴露) 来定义COPD的相关性.
主要成果:
- 在4336名患者中,临床医生分配了COPD诊断,与更多的恶化和更差的生活质量有关.
- 观察到COPD的过度诊断,22.2%缺乏气流阻塞,31.9%缺乏足够的吸烟史.
- 根据ROSE标准确定2,157名患者 (55.4%) 患有与支气管切除相关的COPD,显示出恶化和住院的风险增加.
结论:
- 支气管切除症患者的COPD诊断通常基于主观的标准,缺乏客观的阻塞或吸烟史的证据.
- 被标记为COPD但不符合客观标准的患者仍然表现出更差的临床结果.
- 像ROSE这样的标准化标准对于准确的诊断和了解COPD在支气管切除中的真正影响至关重要.
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