Asthma attacks with eosinophilia predict mortality from chronic obstructive pulmonary disease in a general population sample
Asthma attacks with eosinophilia predict mortality from chronic obstructive pulmonary disease in a general population sample
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DOI：
10.1164/ajrccm.160.6.9811041
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发表时间：
1999-12-01
影响因子：
24.7
通讯作者：
Postma, DS
中科院分区：
文献类型：
--
作者：
Hospers, JJ;Schouten, JP;Postma, DS
在调整主要危险因素后，我们研究了过敏定义为嗜酸性粒细胞增多（大于或等于275个细胞/毫米(3)）和/或皮肤试验阳性（总评分大于或等于3）与慢性阻塞性肺疾病（COPD）死亡率之间的关系。此外，我们在呼吸症状和肺功能亚组中调查了这种关联。我们使用了1964-1972年Vlagtwedde、Vlaardingen和Meppel（荷兰，60年代平均年龄+/- SD: 39.3岁+/- 14岁）一般人群中7556名呼吸系统调查参与者的数据。1995年，可获得生命状态(5135人存活，106人随访失败，121人死于慢性阻塞性肺病，2194人死于其他主要原因，其中137人死于慢性阻塞性肺病。皮肤试验阳性与COPD死亡率增加无关。嗜酸性粒细胞增多症与COPD死亡率之间的关联仅限于那些报告哮喘发作且COPD为主要原因（相对危险度[RR] = 4.80； 95%可信区间[CI] 1.9至11.9）和主要和次要原因合并死亡（RR = 3.90; 95% CI 2.05至7.40）的患者。我们得出结论，嗜酸性粒细胞增多伴哮喘发作是COPD死亡率的一个危险因素，除了我们研究中发现的已知危险因素，如男性、年龄较大、当前吸烟、肺功能低下、体重不足和呼吸困难。
We studied the association between allergy defined as eosinophilia (greater than or equal to 275 cells/mm(3)) and/or positive skin tests (sum score greater than or equal to 3) and mortality from chronic obstructive pulmonary disease (COPD) after adjustment for major risk factors. In addition, we investigated this association in subgroups of respiratory symptoms and lung function. We used data from 7,556 participants of the respiratory surveys in 1964-1972 in the general populations of Vlagtwedde, Vlaardingen, and Meppel (The Netherlands; mean age +/- SD: 39.3 yr +/- 14 in the 1960s). In 1995, the vital status was available (5,135 alive, 106 lost to follow-up, 121 primary deaths from COPD, and 2,194 other primary causes of which 137 had a secondary death cause from COPD. Positive skin tests were not associated with increased COPD mortality. The association between eosinophilia and COPD mortality was restricted to those who had reported asthma attacks and was present for both COPD as a primary cause (relative risk [RR] = 4.80; 95% confidence interval [CI] 1.9 to 11.9) and combined primary and secondary causes of death (RR = 3.90; 95% CI 2.05 to 7.40). We conclude that eosinophilia with asthma attacks is a risk factor for COPD mortality in addition to known risk factors also found in our study such as male gender, older age, current smoking, low lung function, underweight, and dyspnea.