年龄和吸烟数量可以预测COPD患者死亡率

别**料

纽约（路透社健康频道）9月7日电　――　患者年龄和一段时间的吸烟数量可以预测慢性阻塞性肺病患者的死亡率，研究人员说。


       研究人员在9月4日的奥地利维也纳欧洲呼吸学会年会上报告说，肺量测定结果不是预测指标，“年龄和吸烟累积数量是死亡率的重要预测指标，早期发现COPD对疾病早期阶段落实戒烟措施至关重要，” Dr. Saher Shaker在电子邮件中告诉路透社健康频道，他领导了丹麦哥本哈根Gentofte医院的这项研究。


       10年间，Dr. Shaker领导的研究小组检查了208例中至重度COPD患者。期间，104例患者死亡，中位生存时间10.4年。


       多变量分析显示，具有显著性统计学意义的死亡率预测指标包括：年龄(p=0.005)、吸烟包年－数(p=0.02)和计算机体层扫描RA-910（相对肺气肿面积低于-910亨斯菲尔德单位）(p=0.017)。


       肺功能检查，包括1秒钟用力呼气量（FEV1）和肺一氧化碳弥散量（DLCO），不属于具有统计学意义的预测指标。


       这些结果让人惊讶，Dr. Shaker说。


       “不过，”他指出，“肺量测定法对确立诊断和评估疾病严重程度很重要。CT肺气肿程度与疾病病理程度密切相关，在预测方面比肺功能检查更占优势。”

       编译自：Age and the Amount of Tobacco Smoked May Predict COPD Mortality，Medscape，2012年9月7日



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英文全文见下：
Age and the Amount of Tobacco Smoked May Predict COPD Mortality

NEW YORK (Reuters Health) Sep 07 - A patient's age and the number of cigarettes smoked over time can predict mortality in cases of chronic obstructive pulmonary disease, researchers say.

Spirometry results were not a predictor, they reported September 4 at the European Respiratory Society's annual meeting in Vienna, Austria.

"As both age and the accumulated tobacco consumption are significant predictors of mortality, early detection of COPD is essential to provide smoking cessation interventions in the earlier stages of the disease," Dr. Saher Shaker, who led the study at Gentofte Hospital in Copenhagen, Denmark, told Reuters Health by email.

Over the course of 10 years, Dr. Shaker's team examined 208 patients with moderate to severe COPD. In that time, 104 patients died, and the median survival time was 10.4 years.

On multivariate **ysis, statistically significant predictors of mortality, included age (p=0.005), pack years (p=0.02), and RA-910 (relative area of emphysema below -910 Hounsfield units) as measured by computed tomography (p=0.017).

Lung function tests, including forced expiratory volume in one second (FEV1), and the diffusing capacity of the lung for carbon monoxide (DLCO), were not statistically significant predictors.

That came as a surprise, Dr. Shaker said.

"However," he pointed out, "spirometry is important to establish the diagnosis and assess disease severity. The degree of emphysema assessed by CT correlates closely to the pathological extent of the disease, which might explain its prognostic superiority to lung function."