Clinical features of Japanese patients with exacerbations of chronic obstructive pulmonary disease.
Clinical features of Japanese patients with exacerbations of chronic obstructive pulmonary disease.
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DOI：
10.1186/s12890-020-01362-w
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发表时间：
2020-12-07
影响因子：
3.1
通讯作者：
Sueoka-Aragane N
中科院分区：
文献类型：
--
作者：
Tashiro H;Kurihara Y;Takahashi K;Sadamatsu H;Haraguchi T;Tajiri R;Takamori A;Kimura S;Sueoka-Aragane N
病情加重是慢性肺阻塞性疾病 (COPD) 的关键事件。 COPD 恶化的频率与预后（包括死亡率）相关，但尚未建立有用的生物标志物。本回顾性研究调查了 481 名 COPD 患者。比较经历过严重恶化的患者（n = 88，18.3%）和从未经历过严重恶化的患者（n = 393，81.7%）稳定期的临床特征。在经历急性加重的患者中，还比较了频繁加重（加重率 ≥ 2次/年，n = 27, 30.7%）和不频繁加重（1次/年，n = 61, 69.3%）之间的临床特征。与从未出现过加重的COPD患者相比，有加重期的COPD患者的体重指数（BMI）、血清白蛋白和肺功能显着降低，心血管疾病合并症率、COPD评估测试评分、改良医学研究委员会呼吸困难量表以及长期氧疗、长效β2肾上腺素能激动剂治疗、吸入皮质类固醇治疗和大环内酯类治疗的使用率显着升高（全部p < 0.01）。在经历病情加重的患者中，与不频繁加重的患者相比，频繁加重的患者 1.0 秒用力呼气量百分比显着较低，且严重急性加重的风险、血液嗜酸性粒细胞百分比、机械通气使用史、长期氧疗和大环内酯类药物治疗史均高于不频繁加重的患者（所有 p<0.01）。在多变量分析中，血液嗜酸性粒细胞百分比是与恶化频率最相关的参数（β值[95%置信区间]1.45[1.12-1.88]，p<0.01）。稳定期的血液嗜酸性粒细胞是与严重急性加重频率最相关的因素。试验登记：对本研究中的患者进行回顾性登记
Exacerbations are critical events in chronic pulmonary obstructive disease (COPD). The frequency of COPD exacerbations is associated with the prognosis, including mortality, but no useful biomarker has been established. The present retrospective study investigated 481 COPD patients. Clinical features in the stable period were compared between patients who experienced severe exacerbation (n = 88, 18.3%) and those who never experienced severe exacerbation (n = 393, 81.7%). In the patients who experienced exacerbations, clinical features were also compared between frequent exacerbators (exacerbation rate ≥ 2 times/year, n = 27, 30.7%) and infrequent exacerbators (1 time/year, n = 61, 69.3%). Compared to COPD patients who never experienced exacerbations, body mass index (BMI), serum albumin, and pulmonary functions were significantly lower, and the cardiovascular disease comorbidity rate, COPD assessment test score, modified Medical Research Council dyspnea scale, and use of long-term oxygen therapy, long-acting β2 adrenergic agonist therapy, inhaled corticosteroid therapy, and macrolide therapy were significantly higher in COPD patients with exacerbations (all p < 0.01). In patients who experienced exacerbations, frequent exacerbators had significantly lower % forced expiratory volume in 1.0 s and a higher risk of critical exacerbations, percentage of blood eosinophils, history of mechanical ventilation use, and use of long-term oxygen therapy and of macrolide therapy than infrequent exacerbators (all p < 0.01). On multivariate analysis, the percentage of blood eosinophils was the parameter most correlated with exacerbation frequency (β value [95% confidence interval] 1.45 [1.12–1.88], p < 0.01). Blood eosinophil in the stable period is the factor most correlated with the frequency of severe exacerbations. Trial registration: The patients in this study was registered retrospectively
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DOI：
10.2147/copd.s106160
发表时间：
2016
影响因子：
2.8
作者：
Hillas G;Perlikos F;Tzanakis N
通讯作者：
Tzanakis N
DOI：
10.2147/copd.s94259
发表时间：
2015
影响因子：
2.8
作者：
Kerkhof M;Freeman D;Jones R;Chisholm A;Price DB;Respiratory Effectiveness Group
通讯作者：
Respiratory Effectiveness Group
DOI：
10.2147/copd.s34186
发表时间：
2012
影响因子：
2.8
作者：
Halpin DM;Decramer M;Celli B;Kesten S;Liu D;Tashkin DP
通讯作者：
Tashkin DP
影响因子：
10
作者：
Pavord ID;Lettis S;Locantore N;Pascoe S;Jones PW;Wedzicha JA;Barnes NC
通讯作者：
Barnes NC
影响因子：
24.3
作者：
Spencer, S;Calverley, PMA;Jones, PW
通讯作者：
Jones, PW