四十年来低吸烟暴露和COPD的发展和预后:基于人口的队列研究
Yunus Çolak1,2, Anders Løkke3,4, Jacob L Marott5
1Department of Respiratory Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.
即使吸烟暴露率低于10包年,个体也面临患慢性阻塞性肺病 (COPD) 的风险增加. 这种情况显著提高了严重恶化和过早死亡的机会.
科学领域:
- 肺部医学 肺部医学
- 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 (COPD) 诊断通常需要显著的吸烟史 (>10包年).
- 低吸烟暴露对COPD风险和预后的影响仍然不太清楚.
- 这项研究调查了吸烟者在不到10包年暴露期间的COPD发展和结果.
研究的目的:
- 为了测试低吸烟暴露 (<10包年) 增加COPD风险的假设.
- 评估长期预后,包括恶化和死亡率,对于患有慢性肺炎的低吸烟暴露人群.
主要方法:
- 从哥本哈根城市心脏研究中跟踪了6098名非阻碍性成年吸烟者.
- 根据螺旋计标准定义的COPD (预测FEV1/FVC<0.70和FEV1<80%).
- 评估了COPD在5年的发展和40年的临床结果 (恶化,死亡),以吸烟暴露分层.
主要成果:
- 29%的吸烟者在5年内患上了COPD;23%的人在基线时有<10包年.
- 与非COPD,<10包年吸烟者相比,患有COPD和<10包年吸烟者的恶化风险增加了2.83倍.
- 无论吸烟几年,COPD诊断与所有原因死亡率的显著增加有关 (HRs从1.31到1.81).
结论:
- 低吸烟暴露 (<10包年) 在5年内显著增加中年成人中慢性肺炎的风险.
- 患有COPD和低吸烟暴露的个人在40年内面临更高的严重恶化和早期死亡风险.
- 目前对COPD的诊断值可能低估了大量吸烟者的风险.
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