Characteristics of Patients with Chronic Obstructive Pulmonary Disease Exposed to Different Environmental Risk Factors: A Large Cross-Sectional Study.
Characteristics of Patients with Chronic Obstructive Pulmonary Disease Exposed to Different Environmental Risk Factors: A Large Cross-Sectional Study.
复制标题
暴露于不同环境风险因素的慢性阻塞性肺疾病患者的特征：一项大型横断面研究。
DOI：
10.2147/copd.s267114
复制
发表时间：
2020
影响因子：
2.8
通讯作者：
Chen P
中科院分区：
文献类型：
--
作者：
Duan JX;Cheng W;Zeng YQ;Chen Y;Cai S;Li X;Zhu YQ;Chen M;Zhou ML;Ma LB;Liu QM;Chen P
吸烟、生物质烟雾和职业暴露是慢性阻塞性肺疾病（COPD）的主要危险因素。本研究分析了COPD患者队列中暴露于这些因素的数据，并评估了他们在人口统计学和临床特征方面的差异。该横断面观察性研究于2016年11月至2019年12月进行。入选标准为年龄大于40岁，使用支气管扩张剂后1秒用力呼气量（FEV 1）/用力肺活量（FVC）<0.7的患者。在基线时，记录人口统计学特征和暴露史。此外，通过COPD评估试验（CAT）和改良医学研究理事会量表（mMRC）评估呼吸道症状。使用广义线性混合模型调整潜在混杂因素。最终分析共纳入5183例COPD患者。结果表明，烟草暴露与其他危险因素联合使用时，CAT评分（16.0 ± 6.7vs15.3 ± 6.3，P = 0.003）和呼吸困难程度（mMRC ≥ 2的患者占71.5%vs61.6%，P < 0.001）明显高于单纯烟草暴露。此外，仅暴露于生物质烟雾的COPD患者的CAT评分高于仅暴露于烟草或职业烟雾的患者（分别为17.5 ± 6.3 vs 15.3 ± 6.3和15.2 ± 6.3，每次比较P < 0.05），并且更可能是女性和老年人。职业暴露组COPD患者呼吸困难发生率高于单纯烟草暴露组（70.8% vs61.6%，P < 0.05），单纯生物质烟雾暴露组COPD患者呼吸困难发生率也高于单纯烟草暴露组（74.2% vs61.6%，P < 0.05）。即使在调整潜在混杂因素后，这种差异仍然很大。吸烟、生物质烟雾和职业暴露的COPD患者之间存在显著的人口统计学和临床差异。
Tobacco smoking, biomass smoke, and occupational exposure are the main risk factors for chronic obstructive pulmonary disease (COPD). The present study analyzes data on exposure to these factors in a cohort of patients with COPD and assesses their differences in demographic and clinical characteristics. The cross-sectional observational study was conducted from November 2016 to December 2019. Inclusion criteria were patients aged over 40 years old with post-bronchodilator forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) <0.7. At baseline, demographic features and exposure history were recorded. Moreover, respiratory symptoms were assessed by the COPD Assessment Test (CAT) and modified Medical Research Council scale (mMRC). A generalized linear mixed model was used to adjust for potential confounders. A total of 5183 patients with COPD were included in the final analysis. The results demonstrate that exposure to tobacco combined with other risk factors resulted in significantly higher CAT scores (16.0 ± 6.7 vs 15.3 ± 6.3, P = 0.003) and more severe dyspnea (patients with mMRC ≥ 2, 71.5% vs 61.6%, P < 0.001) than exposure to tobacco alone. In addition, COPD patients with biomass smoke exposure alone had higher CAT scores than patients with only tobacco or occupational exposure (17.5 ± 6.3 vs 15.3 ± 6.3, and 15.2 ± 6.3, respectively, P < 0.05 for each comparison) and were more likely to be female and older. In addition, COPD patients who suffered from occupational exposure developed more severe dyspnea than those exposed to tobacco alone (70.8% vs 61.6%, P < 0.05), as did those exposed to biomass smoke alone (74.2% vs 61.6%, P < 0.05). This difference remained strong even after adjustment for potential confounders. There are significant demographic and clinical differences among COPD patients with tobacco smoking, biomass smoke, and occupational exposures.