Respiratory viral infections in adults with and without chronic obstructive pulmonary disease
Respiratory viral infections in adults with and without chronic obstructive pulmonary disease
复制标题
DOI：
10.1164/ajrccm.162.1.9911019
复制
发表时间：
2000-07-01
影响因子：
24.7
通讯作者：
Atmar, RL
中科院分区：
文献类型：
--
作者：
Greenberg, SB;Allen, M;Atmar, RL
对登记时按FEV1分层的慢性阻塞性肺疾病(COPD)老年患者进行了纵向队列研究，以确定呼吸道病毒感染(RTVI)的病因、频率、严重性和医疗影响。对照组由一组与患者年龄相仿的受试者组成。在观察到的急性呼吸道疾病中，44%的对照组和27%的COPD患者记录了RTVI，他们分别平均随访了35和26个月。在这个大量接种流感疫苗的队列中(类似于每年接种90%)，最常见的是小核糖核酸病毒、副流感病毒和冠状病毒。每组患者恢复到临床基线的平均时间约为2wk。对照组和有轻度呼吸道阻塞(基线FEV1大于或等于50%预测)的COPD患者很少去急救中心就诊或住院。大约一半的中/重度COPD患者(基线FEV1和Lt；50%预测)至少有一次因急性呼吸道疾病而到急救中心就诊和/或住院。在12月至3月期间，23%的住院患者和45%的患者记录了RTVI。呼吸道感染对有中、重度呼吸道阻塞的慢性阻塞性肺疾病患者的医疗资源利用有重要影响。
A longitudinal cohort study of older adults with chronic obstructive pulmonary disease (COPD) who were stratified by FEV1 at enrollment was done to define the etiology, frequency, severity, and medical-care impact of respiratory tract viral infections (RTVIs). Controls consisted of a group of subjects of comparable age with the patients. RTVIs were documented in 44% of observed acute respiratory illnesses in control subjects and in 27% of COPD subjects, who were followed for mean periods of 35 and 26 mo, respectively. In this heavily influenza-vaccinated cohort (similar to 90% vaccinated each year), picornaviruses, parainfluenza viruses, and coronaviruses were most commonly identified. Mean time to return to clinical baseline was approximately 2 wk in each group. Control and COPD subjects with mild airways obstruction (baseline FEV1 greater than or equal to 50% predicted) had few emergency-center visits or hospitalizations. Approximately half of COPD subjects with moderate/severe COPD (baseline FEV1 < 50% predicted) had at least one emergency-center visit and/or hospitalization for acute respiratory illness. RTVIs were documented in 23% of hospitalizations and in 45% of patients admitted between December and March. RTVIs have a major impact on utilization of health care resources for COPD patients with moderate/severe airways obstruction.