慢性阻塞性肺病的脆弱性和恶化:有任何关联吗?
Koichi Nishimura1,2, Masaaki Kusunose3, Ryo Sanda3
1National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
患有慢性阻塞性肺病 (COPD) 的脆弱个体面临更高的恶化和住院的风险. 虚弱是显著的风险因素,但肺功能 (FEV1) 是这些事件的更强的预测因素.
科学领域:
- 老年学是一门学科.
- 肺部病理学 肺部病理学
- 临床医学 临床医学
背景情况:
- 虚弱是慢性阻塞性肺病 (COPD) 管理中的一个日益关注的问题.
- 了解虚弱对COPD恶化和住院治疗的影响对于患者的治疗结果至关重要.
研究的目的:
- 调查COPD脆弱性与急性恶化风险 (AECOPD) 与稳定的COPD门诊患者住院治疗之间的关联.
- 为了比较虚弱与肺功能 (FEV1) 对COPD患者未来不良事件的预测能力.
主要方法:
- 一组由135名稳定的COPD门诊患者组成的队列被跟踪长达6.5年.
- 参与者使用Kihon检查清单被分为强壮,前脆弱或脆弱.
- 考克斯的比例危险模型被用于评估AECOPD和住院的风险,并根据FEV1和性别进行调整.
主要成果:
- 与强壮患者相比,脆弱的COPD患者患有AECOPD (HR 1.762) 和住院 (HR 2.238) 的风险明显更高.
- 在强壮和脆弱前,或脆弱前和脆弱前的组之间,没有发现严重恶化或住院风险的显著差异.
- 肺功能 (FEV1) 显示出对恶化和住院的预测能力比脆弱性措施更强.
结论:
- 与强壮个体相比,脆弱性是COPD患者恶化和住院病例增加的独立风险因素.
- 与脆弱性相关的风险增加主要在将脆弱患者与健壮患者进行比较时显而易见.
- FEV1仍然是COPD未来不良事件的更强有力的预测因素,而不是脆弱性评估.
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