患有COPD的年轻患者急性恶化和疾病进展的危险因素
Juye Bae1, Hyo Jin Lee2, Kwang Yong Choi3
1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of).
BMJ open respiratory research
|July 17, 2024
概括
喘病史,肺气和高乙酸细胞计数预测年轻的COPD患者的恶化. 以前的呼吸道疾病和症状也表明疾病进展和早期治疗需要.
科学领域:
- 肺部病理学 肺部病理学
- 临床医学 临床医学
- 呼吸系统研究 呼吸系统研究
背景情况:
- 慢性阻塞性肺病 (COPD) 通常影响老年人,但年轻患者的一个子集经历了显著的疾病负担.
- 在年轻的COPD患者中确定恶化和进展的早期临床预测因素对于及时干预至关重要.
研究的目的:
- 确定与20-50岁的COPD患者急性恶化和疾病进展相关的临床因素.
- 为了确定中度至严重恶化的风险因素,早期启动吸入疗法,以及加速的肺功能下降.
主要方法:
- 在342名慢性肺炎患者 (20-50岁) 中进行了回顾性纵向观察性研究,后支气管扩展剂FEV1/FVC<0.7.7.
- 随访包括诊断后1年间隔至少两次螺旋计测试.
- 多变量分析评估了主要 (恶化) 和次要结果 (治疗开始,FEV1下降) 的风险因素.
主要成果:
- 喘病史 (aHR=2.999),肺气 (aHR=1.951),血中乙氨基 >300/μL (aHR=1.469),以及低FEV1% (aHR=0.979) 与恶化有关.
- 喘病史,唾液,高乙酸细胞,低FEV1%,低DLCO%预测了早期的吸入治疗.
- 增加年龄,女性性别,先前结核病,吐,低FEV1%和低DLCO%与更快的FEV1下降有关.
结论:
- 年轻的COPD患者有喘病史,肺气,血中乙氨基升高或FEV1%低,面临着更高的恶化风险.
- 过去的呼吸道疾病,当前的症状,乙酸细胞计数和肺功能障碍是年轻COPD患者疾病进展和早期治疗的关键指标.
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