CHRONIC MUCUS HYPERSECRETION IN COPD AND DEATH FROM PULMONARY INFECTION
CHRONIC MUCUS HYPERSECRETION IN COPD AND DEATH FROM PULMONARY INFECTION
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DOI：
10.1183/09031936.95.08081333
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发表时间：
1995-08-01
影响因子：
24.3
通讯作者：
VESTBO, J
中科院分区：
文献类型：
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作者：
PRESCOTT, E;LANGE, P;VESTBO, J
慢性粘液高分泌与死亡率的关系是一个有争议的问题，我们希望确定慢性粘液高分泌与慢性阻塞性肺疾病(COPD)相关死亡率之间的关系是否可以用肺部感染的倾向来解释。我们对14,223名男女受试者进行了10-12年的跟踪调查，纳入了脐带是潜在或促成死亡的病例(n=214)，并尽可能获得了住院记录(n=101)，根据胸片上粘液增加、化脓性粘液、发热、白细胞增多和渗透，死亡被归类为肺部感染(n=38)，其他原因(n=51)，在最初报告慢性粘液高分泌的受试者中，54%的死亡与肺部感染有关，而在没有慢性粘液高分泌的受试者中，这只发生在28%的受试者中，控制了协变量，特别是吸烟习惯，COX分析显示，呼吸功能与COPD相关死亡率之间存在强烈的负相关，慢性粘液高分泌是合并肺部感染的脐带相关死亡的显著预测因子(相对危险度(RR)3.5)，但不是无肺部感染死亡的显著预测因子(RR 0.9)。我们认为COPD和慢性粘液高分泌的患者比没有慢性粘液高分泌的患者更有可能死于肺部感染，这可能解释了先前研究中发现的COPD和慢性粘液高分泌患者的高死亡率。
The association of chronic mucus hypersecretion and mortality is a matter of debate, We wished to determine whether the relationship between chronic mucus hypersecretion and chronic obstructive pulmonary disease (COPD)-related mortality could be explained by proneness to pulmonary infection.We followed 14,223 subjects of both sexes for 10-12 yrs, Cases where CORD was an underlying or contributory cause of death (n = 214) were included, and hospital records were obtained when possible (n = 101), From the presence of increased mucus, purulent mucus, fever, leucocytosis and infiltration on chest radiography, death was classified as either due to pulmonary infection (n = 38), other causes (n = 51), or unclassifiable (n = 12).Of subjects reporting chronic mucus hypersecretion at the initial examination, pulmonary infection was implicated in 54%, of deaths, whereas this only occurred in 28% of subjects without chronic mucus hypersecretion, Controlling for covariates, in particular smoking habits, a Cox analysis showed a strong inverse relationship between ventilatory function and COPD-related mortality, Chronic mucus hypersecretion was found to be a significant predictor of CORD-related death with pulmonary infection implicated (relative risk (RR) 3.5) but not of death without pulmonary infection (RR 0.9).We consider that subjects with COPD and chronic mucus hypersecretion are more likely to die from pulmonary infections than subjects without chronic mucus hypersecretion, This may explain the excess mortality in subjects with COPD and chronic mucus hypersecretion found in previous studies.