Advanced emphysema in African-American and white patients - Do differences exist?
Advanced emphysema in African-American and white patients - Do differences exist?
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DOI：
10.1378/chest.130.1.108
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发表时间：
2006-07-01
期刊：
影响因子：
9.6
通讯作者：
Criner, Gerard J.
中科院分区：
文献类型：
--
作者：
Chatila, Wissam M.;Hoffman, Eric A.;Criner, Gerard J.
背景资料：肺气肿是唯一的吸烟相关疾病，其中白色患者的患病率和归因死亡率高于非洲裔美国患者。流行病学研究没有解决，也没有解释，观察到的种族差异在emphysema.Study objectives：为了确定是否白色和非洲裔美国人的患者不同方面的规模，解剖分布，和生理损害的emphysema.Patients：严重和非常严重的肺气肿患者的特征，在国家肺气肿治疗试验登记进行了检查和比较。患者的人口统计学资料，心肺功能，生活质量，肺气肿的严重程度/分布的定量CT进行了analyzed.Results：在1,218例患者参加了试验，42名非洲裔美国人（3.4%）和1,156名白色（95%）。与白色患者相比，非裔美国人更年轻（平均年龄+/- SD，63 +/- 7岁vs 67 +/- 6岁），吸烟量更少（每天26 +/- 14支vs 32 +/- 14支）（p = 0.01）。两个种族组在肺功能（FEV，27 +/- 6%预测值vs 27 +/- 7%预测值）、气体交换（Pa-O2，66 +/- 11 mm Hg vs 65 +/- 10 mm Hg）和运动（33 +/- 14 W vs 36 +/- 21 W）方面没有差异。两组之间的生活质量指标相似，但非洲裔美国人的社会经济地位较低，教育水平较低，结婚人数较少。与选定的白色患者相匹配的非裔美国人肺气肿程度的放射学分析显示，前者肺气肿明显较少，严重肺气肿的分布不同。患有肺气肿的非裔美国人更年轻，尽管吸烟较少，但与白色研究人群的肺损伤程度相似。肺气肿的严重程度和分布在放射学定量分析中存在差异。
Background: Emphysema is the only smoking-related disease in which white patients have higher prevalence and higher attributable mortality rates than African-American patients. Epidemiologic studies have not addressed, nor explained, the observed racial differences in emphysema.Study objectives: To determine whether white and African-American patients differ with respect to the magnitude, anatomic distribution, and physiologic impairments of emphysema.Patients: Characteristics of patients with severe and very severe emphysema enrolled in the National Emphysema Treatment Trial were examined and compared. Patient demographics, cardiopulmonary function, quality of life, and severity/distribution of the emphysema by quantitative CT were analyzed.Results: Of the 1,218 patients enrolled in the trial, 42 were African American (3.4%) and 1,156 were white (95%). African Americans were younger (mean age +/- SD, 63 +/- 7 years vs 67 +/- 6 years) and smoked less (26 +/- 14 cigarettes per day vs 32 +/- 14 cigarettes per day) than white patients (p = 0.01). There was no difference between the two racial groups in pulmonary function (FEV, 27 +/- 6% predicted vs 27 +/- 7% predicted), gas exchange (Pa-O2, 66 +/- 11 mm Hg vs 65 +/- 10 mm Hg), and exercise (33 +/- 14 W vs 36 +/- 21 W), respectively. Quality of life measures were similar between the groups, but African Americans had a lower socioeconomic status, lower education level, and fewer were married. Radiographic analysis of the extent of emphysema in African Americans, who were matched with selected white patients, revealed significantly less emphysema in the former group and different distribution of severe emphysema.Conclusions: African Americans with emphysema were younger and had a similar degree of lung impairment as the white study population despite smoking less. In a subgroup of matched patients, the severity and distribution of emphysema by quantitative radiographic analysis were different.