Am J Respir Crit Care Med:儿童肺功能可预测成人COPD和哮喘 - COPD重叠综合征(ACOS)

2017-02-15 MedSci MedSci原创

7岁时肺功能最低四分位数对中年COPD和ACOS的发生可能有长期的影响。在学龄儿童中筛选肺功能水平可能可以作为针对性干预的高风险群体。

目前关于COPD表型的早期生活危险因素的研究数据有限。

为了研究儿童肺功能在成人肺活量测定的COPD表型中的作用,本研究对塔斯马尼亚7岁的儿童队列进行支气管扩张剂(BD)前肺功能检测。子样本则在45岁进行BD前和BD后肺功能检测。对于该分析,通过肺功能检测定义COPD为BD后FEV1 / FVC <正常下限(LLN)。哮喘 - COPD重叠综合征(ACOS)被定义为COPD和当前哮喘两者共存。使用多项回归评估儿童肺功能和哮喘/ COPD / ACOS之间的关联。

在45岁时,有959名受试者目前没有哮喘和COPD,269例仅有哮喘,59例仅有COPD,68例有ACOS。单独哮喘,单独COPD和ACOS的流行率重新加权分别为13.5%,4.1%和2.9%。 7岁时FEV1的最低四分位数与ACOS呈相关性(OR = 2.93; 95%CI,1.32-6.52),但与单独COPD或单独哮喘无关。FEV1 / FVC比值的最低四分位数与ACOS(OR = 16.3; 95%CI,4.7-55.9)和单独COPD(OR = 5.76; 95%CI 1.9-17.4)呈相关性,但与单独哮喘不相关。

7岁肺功能最低四分位数对中年COPD和ACOS的发生可能有长期的影响。在学龄儿童中根据肺功能水平筛选出高风险群体从而进行有针对性的干预。而要了解这些相关性的可能调节作用以及对肺功能受损的儿童实施干预措施还需要进一步的研究。

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CHEST:COPD患者中哮喘-COPD重叠综合征的定义

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