Histamine airway hyper-responsiveness and mortality from chronic obstructive pulmonary disease: a cohort study
Histamine airway hyper-responsiveness and mortality from chronic obstructive pulmonary disease: a cohort study
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DOI：
10.1016/s0140-6736(00)02815-4
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发表时间：
2000-10-14
期刊：
影响因子：
168.9
通讯作者：
Schouten, JP
中科院分区：
文献类型：
--
作者：
Hospers, JJ;Postma, DS;Schouten, JP
由组胺气道高反应性表达的背景吸烟和气道不稳定是呼吸道症状发展的已知危险因素。吸烟也与死亡率增加有关。我们研究了气道高反应性是否与死亡率增加有关，以及这种风险是否与吸烟和肺功能减少有关。我们跟进了2008年的2008年弗拉格特维德（Vlagtwedde），弗拉德丁根（Vlaardingen）和梅佩尔（Mepppel）（荷兰）的居民，他们遇到了组胺挑战（荷兰）测试数据，1964 - 72年30年。随访是99％的成功（29名患者随访），有1453名参与者和526例死亡（246例心血管疾病死亡，54例死亡，肺癌54例，慢性阻塞性肺疾病[COPD]。 COPD增加了更严重的高反应性； 3.83（95％CI 0.97-15.1），4.40（1.16-16.7），4.78（1.27-18.0），6.69（1.71-26.1）和15.8（3.72-67.1）的相对风险与组胺阈值相关， l，16 g/l，8 g/l，4 g/l和1 g/l，与no相比高反应性。这些风险是针对性别，年龄，吸烟，肺功能，身体质量指数，阳性皮肤测试，嗜酸性粒细胞，哮喘和居住城市调整的。解释增加了组胺气道高反应性，可以预测COPD的死亡率。尽管吸烟者的这种趋势更为明显，但在从未吸烟的个体中，COPD死亡的比例越来越高。
Background Smoking and airway lability, which is expressed by histamine airway hyper-responsiveness, are known risk factors for development of respiratory symptoms. Smoking is also associated with increased mortality risks. We studied whether airway hyper-responsiveness is associated with increased mortality, and whether this risk was independent of smoking and reduced lung function.Methods We followed up 2008 inhabitants of the communities of Vlagtwedde, Vlaardingen, and Meppel (Netherlands), who had histamine challenge test data, from 1964-72 for 30 years. Follow-up was 99% successful (29 patients lost to follow-up) with 1453 participants alive and 526 deaths (246 died from cardiovascular disease, 54 from lung cancer, and 21 from chronic obstructive pulmonary disease [COPD]).Findings Mortality from COPD increased with more severe hyper-responsiveness; relative risks of 3.83 (95% CI 0.97-15.1), 4.40 (1.16-16.7), 4.78 (1.27-18.0), 6.69 (1.71-26.1), and 15.8 (3.72-67.1) were associated with histamine thresholds of 32 g/L, 16 g/L, 8 g/L, 4 g/L, and 1 g/L, respectively, compared with no hyper-responsiveness. These risks were adjusted for sex, age, smoking, lung function, body-mass index, positive skin tests, eosinophilia, asthma, and city of residence.Interpretation Increased histamine airway hyperresponsiveness predicts mortality from COPD. Although this trend was more pronounced in smokers, an increasing proportion of COPD deaths with increasing hyperresponsiveness was also present among individuals who had never smoked.