Incidence of chronic obstructive pulmonary disease in a cohort of young adults according to the presence of chronic cough and phlegm
Incidence of chronic obstructive pulmonary disease in a cohort of young adults according to the presence of chronic cough and phlegm
复制标题
DOI：
10.1164/rccm.200603-381oc
复制
发表时间：
2007-01-01
影响因子：
24.7
通讯作者：
Burney, Peter
中科院分区：
文献类型：
--
作者：
de Marco, Roberto;Accordini, Simone;Burney, Peter
基本原理：少数前瞻性研究旨在评估慢性阻塞性肺疾病（COPD）的发病率与慢性咳嗽/痰的存在产生了对比result.Objectives：评估COPD的发病率在一个队列的年轻人，并测试慢性咳嗽/痰和呼吸困难是否是COPD的独立预测因子。研究方法：在欧洲共同体呼吸健康调查II的框架内，从1991-2002年对来自12个国家的5，002例肺功能正常（FEV 1/FVC比值>= 70%）的无哮喘（年龄20-44岁）受试者进行了国际队列研究。COPD的发病病例是指随访结束时FEV 1/FVC比值小于70%，但在随访期间没有报告有医生诊断为哮喘的病例。主要结果：COPD的发病率为2.8例/1，000/年（95%置信区间[CI]，2.3-3.3）。在调整吸烟习惯和其他潜在混杂因素后，慢性咳嗽/痰是COPD的独立且具有统计学意义的预测因子（发病率比[IRR]，1.85; 95% CI，1.17-2.93），而呼吸困难与疾病无关（IRR = 0.98; 95% CI，0.64-1.50）。在基线和随访时均报告慢性咳嗽/痰的受试者与无症状受试者相比，发生COPD的风险增加近3倍（IRR = 2.88; 95%CI，1.44-5.79）。慢性咳嗽/痰的存在确定了具有发展COPD的高风险的受试者亚组，与吸烟习惯无关。
Rationale: The few prospective studies aimed at assessing the incidence of chronic obstructive pulmonary disease (COPD) in relation to the presence of chronic cough/phlegm have produced contrasting results.Objectives: To assess the incidence of COPD in a cohort of young adults and to test whether chronic cough/phlegm and dyspnea are independent predictors of COPD. Methods: An international cohort of 5,002 subjects without asthma (ages 20-44 yr) with normal lung function (FEV1/FVC ratio >= 70%) from 12 countries was followed from 1991-2002 in the frame of the European Community Respiratory Health Survey II. Incident cases of COPD were those who had an FEV1/FVC ratio less than 70% at the end of the follow-up, but did not report having had a doctor diagnose asthma during the follow-up.Main Results: The incidence rate of COPD was 2.8 cases/1,000/yr (95% confidence interval [CI], 2.3-3.3). Chronic cough/phlegm was an independent and statistically significant predictor of COPD (incidence rate ratio [IRR], 1.85; 95% Cl, 1.17-2.93) after adjusting for smoking habits and other potential confounders, whereas dyspnea was not associated with the disease (IRR = 0.98; 95% Cl, 0.64-1.50). Subjects who reported chronic cough/phlegm both at baseline and at the follow-up had a nearly threefold-increased risk of developing COPD with respect to asymptomatic subjects (IRR = 2.88; 95% Cl, 1.44-5.79).Conclusions: The incidence of COPD is substantial even in young adults. The presence of chronic cough/phlegm identifies a subgroup of subjects with a high risk of developing COPD, independently of smoking habits.