与FEV/FVC比率相关的COPD患者的健康状况和预后
Juan Wang1,2, Björn Ställberg3, Maria Hårdstedt4,5,6,7
1Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden. juan.wang@medsci.uu.se.
NPJ primary care respiratory medicine
|January 8, 2026
概括
使用正常的下限 (LLN) 和固定比率 (FR) 诊断COPD显示患者的症状和疾病负担相似. 这表明,不符合LLN标准并不一定意味着当FEV1可比时,COPD是较轻的.
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) 的诊断受到争议,特别是关于使用正常的下限 (LLN) 与固定FEV1/FVC比率<0.70 (FR) 的使用.
- 了解不同诊断标准的临床影响对于准确的患者管理和预后至关重要.
研究的目的:
- 为了比较使用FR和LLN值 (FR+/LLN+) 诊断的COPD患者和使用FR但不使用LLN (FR+/LLN-) 诊断的COPD患者之间的症状和疾病负担.
- 为了调查临床诊断的COPD与相似的FEV1是否不符合LLN标准,表明疾病状态较轻.
主要方法:
- 一项对来自瑞典中部的初级和中等保健机构的572名COPD患者的队列研究.
- 对FR+/LLN+ (n=194) 和FR+/LLN- (n=85) COPD患者具有相似FEV1水平 (预测≥60%) 的比较.
- 使用mMRC,CAT和CCQ得分评估症状负担. 疾病负担通过三年来恶化和住院患者的评估.
主要成果:
- FR+/LLN+和FR+/LLN-组表现出相似的临床特征,包括预测的FEV1%,吸入药物的使用和以前的恶化.
- 在三年内,两组之间在恶化和住院病例的流行率上没有发现显著差异.
- 虽然mMRC和CCQ得分相似,但FR+/LLN-组报告了更高的CAT得分 (12.6比10.6,p=0.038),这在调整后的分析中是一致的发现.
结论:
- 符合FR和LLN标准 (FR+/LLN+) 和符合FR但不符合LLN标准 (FR+/LLN-) 的COPD患者表现出相对可比的症状和疾病负担.
- 在临床诊断的COPD与相似的FEV1中不符合LLN标准似乎并不意味着一种较轻的疾病.
- 这些发现强调了在COPD管理中考虑诊断参数和整体临床表现的重要性.
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