Impact of bronchodilator use on the prevalence of COPD in population-based samples.
Impact of bronchodilator use on the prevalence of COPD in population-based samples.
复制标题
DOI：
10.1080/15412550701341012
复制
发表时间：
2007-06-01
期刊：
影响因子：
2.2
通讯作者：
Menezes, Ana Maria B
中科院分区：
文献类型：
--
作者：
Perez-Padilla, Rogelio;Hallal, Pedro Curi;Menezes, Ana Maria B
本研究的目的是在一项基于人群的调查（Platino研究）中描述使用支气管扩张剂对慢性阻塞性肺疾病患病率的影响。选择40岁或以上受试者的整群抽样，代表5个拉丁美洲城市（圣保罗、墨西哥、蒙得维的亚、圣地亚哥和加拉加斯）的大都市区。在5183名受试者吸入200 μ g沙丁胺醇之前和之后，根据ATS标准进行肺量测定。使用不同的标准，在使用支气管扩张剂前后进行的测试中，以及使用支气管扩张剂前后的参考值，估计气流阻塞的患病率。支气管扩张剂试验将FEV（1）/FVC% < 0.70的总体患病率从21.7%降至14%（35%）。在使用支气管扩张剂后FEV（1）/FVC < 0.70的组中，21%的患者从呼吸角度来看无症状，并且没有明显的不良暴露。FEV（1）/FVC和FEV（1）/FEV（6）低于第5百分位数的受试者少于FEV（1）/FVC < 0.70的受试者，尤其是老年人。使用支气管扩张剂后使用参考值进行检测时，FEV（1）/FVC和FEV（1）/FEV（6）低于第5百分位数的受试者多于使用未进行支气管扩张剂检测时确定的参考值的受试者。使用支气管扩张剂后进行检测可将气流阻塞的患病率从32%降低至39%，具体取决于所使用的定义。此外，使用支气管扩张剂后仍然阻塞的受试者比可逆性阻塞的受试者表现出更多的呼吸道症状和暴露于烟草和其他烟雾和粉尘，这表明COPD的特异性增加。
The aim of this study was to describe the impact of using bronchodilators on the prevalence of Chronic Obstructive Pulmonary Disease in a population-based survey (Platino study). A cluster sampling of subjects 40 years of age or older, representative of the metropolitan areas of 5 Latin American cities (Sao Paulo, Mexico, Montevideo, Santiago and Caracas) was chosen. Spirometry according to ATS standards was done before and after inhalation of 200 micrograms of salbutamol in 5183 subjects. Prevalences of airflow obstruction were estimated using different criteria, in tests done before and after bronchodilator use, and with reference values for pre- or post-bronchodilator use. Bronchodilator testing reduced the overall prevalence of FEV(1)/FVC% < 0.70 from 21.7% to 14% (35%). In the group with FEV(1)/FVC < 0.70 after bronchodilator use, 21% were asymptomatic from the respiratory point of view, and lacked significant adverse exposures. Subjects below the 5th percentile for FEV(1)/FVC and FEV(1)/FEV(6) were fewer than those with FEV(1)/FVC < 0.70, especially among the elderly. More subjects are below the 5th percentile of FEV(1)/FVC and FEV(1)/FEV(6) using reference values for tests after bronchodilator use than using the reference values determined without bronchodilator testing. Testing after bronchodilator use reduces the prevalence of airflow obstruction from 32 to 39% depending on the definition used. In addition, the subjects who were still obstructed after bronchodilator use were the ones who showed more respiratory symptoms and exposure to tobacco and other smokes and dusts, than subjects with reversible obstruction, suggesting an increased specificity for COPD.