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支气管哮喘及慢性阻塞性肺疾病重叠的女性患者:发病率及危险因素关系

2018/11/02

   摘要
   论据:随着年龄的增长,患有哮喘的女性患COPD或哮喘和COPD重叠综合征(ACOS)的风险很高,其是一种与高死亡率,低生活质量和高医疗成本相关的疾病。 然而,影响ACOS发展的因素仍不清楚。
   目标:为了量化女性哮喘患者患COPD的风险,及确定与风险增加相关的因素。
   结果:本研究共纳入4,051名哮喘女性,其中1,701名(42.0%)患有COPD。 研究结束日期的平均年龄为79岁。 教育水平低,高体重指数,居住僻远及高吸烟指数与ACOS发病率相关,而与接触主要空气污染物(PM2.5)却没有明显相关性。
   结论:独立危险因素显然在女性患者ACOS的发展中比环境因素(如空气污染)更重要。 针对提升健康及教育的预防措施可降低该人群ACOS的发病率。



(中日友好医院呼吸与危重症医学科 张鑫 摘译 林江涛 审校
Ann Am Thorac Soc.2018 Jul 17.


 

Asthma and COPD Overlap in Women: Incidence and Risk Factors.

To T, Zhu J, Gray N, Feldman LY, Villeneuve PJ, Licskai C, Gershon A, Miller AB.

Abstract
RATIONALE: Women with asthma are at a high risk of developing COPD, or asthma and COPD overlap syndrome (ACOS) as they age, which is a condition associated with a high mortality rate, low quality of life, and high healthcare costs. However, factors influencing the development of ACOS remain unclear.
OBJECTIVE: To quantify the risk of developing COPD in Ontario women with asthma and identify factors that are associated with increased risk.
METHODS: Data for Ontario women with asthma who participated in the Canadian National Breast Screening Study from 1980─1985 were linked to health administrative databases and participants were followed from 1992─2015. A competing risks survival model was used to measure the associations between sociodemographic, lifestyle and environmental risk factors and time to COPD incidence, accounting for death as a competing risk.
RESULTS: A total of 4,051 women with asthma were included in the study, of whom 1,701 (42.0%) developed COPD. The mean age at the study end date was 79 years old. Low education, high body mass index, rurality, and high levels of cigarette smoking were associated with ACOS incidence, while exposure to fine particulate matter (PM2.5), a major air pollutant, was not.
CONCLUSION: Individual risk factors appear to play a more significant role in the development of ACOS in women than environmental factors, such as air pollution. Prevention strategies targeting health promotion and education may have the potential to reduce ACOS incidence in this population.




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