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【文摘发布】老年人慢性阻塞性肺疾病的肺功能
Author:David M Mannino1, A Sonia Buist2 and William M Vollmer
Abstract:
Background: The Global Initiative on Obstructive Lung Disease stages for chronic obstructive pulmonary disease (COPD) uses a fixed ratio of the post-bronchodilator forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) of 0.70 as a threshold. Since the FEV1/FVC ratio declines with age, using the fixed ratio to define COPD may "overdiagnose" COPD in older populations.
Objective: To determine morbidity and mortality among older adults whose FEV1/FVC is less than 0.70 but more than the lower limit of normal (LLN).
Methods: The severity of COPD was classified in 4965 participants aged 65 years in the Cardiovascular Health Study using these two methods and the age-adjusted proportion of the population who had died or had a COPD-related hospitalisation in up to 11 years of follow-up was determined.
Results: 1621 (32.6%) subjects died and 935 (18.8%) had at least one COPD-related hospitalisation during the follow-up period. Subjects (n = 1134) whose FEV1/FVC fell between the LLN and the fixed ratio had an increased adjusted risk of death (hazard ratio (HR) 1.3, 95% CI 1.1 to 1.5) and COPD-related hospitalisation (HR 2.6, 95% CI 2.0 to 3.3) during follow-up compared with asymptomatic individuals with normal lung function.
Conclusion: In this cohort, subjects classified as "normal" using the LLN but abnormal using the fixed ratio were more likely to die and to have a COPD-related hospitalisation during follow-up. This suggests that a fixed FEV1/FVC ratio of <0.70 may identify at-risk patients, even among older adults.
http://thorax.bmj.com/cgi/content/full/62/3/237
如需全文pm我 我领了，哈哈 老年慢性阻塞性肺疾病：用什么来界定肺功能异常
Authoravid M Mannino1, A Sonia Buist2 and William M Vollmer
摘要:
背景：以吸入支气管扩张剂后第一秒用力呼气容积与用力肺活量的固定比值0.70作为标准，慢性阻塞性肺疾病全球创意将慢阻肺分为三个阶段。由于 FEV1/FVC的比值随年龄的增长而降低, 采用该比值来界定COPD，在老年人群中可能会造成过度诊断
目的: 研究FEV1/FVC虽然小于0.70但大于正常低限的老年COPD患者的发病率和死亡率。
方法: 在心血管健康研究中采用这两种方法对65岁的4965位受试者依据COPD的严重程度进行分组，在将近11年的随访中，对那些因COPD而死亡或住院者采用年龄校正后进行研究。
结果: 在随访期间，1621 (32.6%) 例死亡， 935 (18.8%)至少有一次因COPD而住院治疗。与肺功能正常的无症状者相比，1134例FEV1/FVC介于LLN与固定比之间者校正后的死亡危险度 (危险度 (HR) 1.3, 95%CI 1.1－1.5)和 COPD相关的住院危险度(HR 2.6, 95%CI 2.0－3.3)增加。
结论: 在本研究中，随访中那些依据LLN 分为正常而依据固定比则不正常者似乎有更高的死亡率和COPD 相关性住院率。这表明即使在老年人中，固定比为0.70能够区别那些危险期患者。
注：正常低限LLN是指不同年龄人群中相应的最低正常肺功能。如图所示 图片来了
screen.width-333)this.width=screen.width-333" width=392 height=208 title="Click to view full lln副本.jpg (392 X 208)" border=0 align=absmiddle> 还真有很多高手阿，刚发出的文章，马上就有人翻译好，还可怜我们这些英语不好的人，实在惭愧啊 怎么不加分啊？版主 文章不足500字，可以后合并加分。 [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-08-14 17:12
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