Emphysema Presence, Severity, and Distribution Has Little Impact on the Clinical Presentation of a Cohort of Patients With Mild to Moderate COPD
Emphysema Presence, Severity, and Distribution Has Little Impact on the Clinical Presentation of a Cohort of Patients With Mild to Moderate COPD
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DOI：
10.1378/chest.10-0984
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发表时间：
2011-01-01
期刊：
影响因子：
9.6
通讯作者：
Zulueta, Javier J.
中科院分区：
文献类型：
--
作者：
de Torres, Juan P.;Bastarrika, Gorka;Zulueta, Javier J.
背景：COPD 患者的表型特征可能具有潜在的预后和治疗意义。关于肺气肿与 COPD 患者临床表现之间关系的现有信息仅限于疾病晚期。本研究的目的是描述肺气肿的存在、严重程度和分布及其对轻度至中度 COPD 患者临床表现的影响。方法：115 名 COPD 患者接受了临床和胸部 CT 扫描评估肺气肿的存在、严重程度和分布。比较患有和不患有肺气肿以及具有不同形式的肺气肿分布（上/下/核心/剥离）的患者。确定肺气肿严重程度和分布对临床表现的影响。结果：50% 的患者有轻度均匀分布的肺气肿（1.84；0.76%-4.77%）。上部和核心区的肺气肿程度较严重。肺气肿患者年龄较大，男性较多，FEV1% 较低，总肺活量百分比较高，肺一氧化碳弥散能力较低。不同肺气肿分布的临床或生理参数之间没有发现差异。结论：在轻至中度COPD患者中，虽然肺气肿的存在对生理表现有影响，但其严重程度和分布似乎对临床表现影响不大。胸部 2011； 139(1):36-42
Background: Phenotypic characterization of patients with COPD may have potential prognostic and therapeutic implications. Available information on the relationship between emphysema and the clinical presentation in patients with COPD is limited to advanced stages of the disease. The objective of this study was to describe emphysema presence, severity, and distribution and its impact on clinical presentation of patients with mild to moderate COPD.Methods: One hundred fifteen patients with COPD underwent clinical and chest CT scan evaluation for the presence, severity, and distribution of emphysema. Patients with and without emphysema and with different forms of emphysema distribution (upper/lower/core/peel) were compared. The impact of emphysema severity and distribution on clinical presentation was determined. Results: Fifty percent of the patients had mild homogeneously distributed emphysema (1.84; 0.76%-4.77%). Upper and core zones had the more severe degree of emphysema. Patients with emphysema were older, more frequently men, and had lower FEV1%, higher total lung capacity percentage, and lower diffusing capacity of the lung for carbon monoxide. No differences were found between the clinical or physiologic parameters of the different emphysema distributions.Conclusions: In patients with mild to moderate COPD, although the presence of emphysema has an impact on physiologic presentation, its severity and distribution seem to have little impact on clinical presentation. CHEST 2011; 139(1):36-42