哮喘-慢性阻塞性肺疾病重叠综合征与肺栓塞危险之间的关系
2016/11/09
摘要
目的:我们进行了一项队列研究来阐明哮喘-慢性阻塞性肺疾病（COPD）重叠综合征（ACOS）和肺栓塞（PE）之间的关系。
方法：从台湾全民健康保险研究数据库，我们挑选出诊断为哮喘和COPD（定义为ACOS）以及同时在1999年一月到2009年12月之间治疗的患者（ACOS队列：n = 14150；非ACOS队列：n = 55876）。Cox比例风险回归分析确定ACOS队列中调整后肺栓塞（PE）的风险比（aHRs），并与非ACOS队列相比较。
结果：比较ACOS队列与非ACOS的队列，肺栓塞（PE）的风险比（aHRs）是2.08（95%置信区间[CIs]：1.56-2.76）。PE的风险比在ACOS组比非ACOS组要高，不论年龄、性别、合并症、吸入性糖皮质激素（ICS）和口服类固醇（OSs）的使用。在ACOS队列中，20岁到65岁的患者，肺栓塞（PE）的风险比（aHRs）是2.53（95% CI：1.44-4.44）。使用ICSs （aHR：1.97，95% CI：1.29-3.01）或OSs（aHR：1.97，95% CI：1.46-2.65）的ACOS患者，PE的风险高于非ACOS队列。PE的风险随着门诊和需要住院治疗的数量的增加而增加，从在3-9次门诊和住院病人中的2.32（95% CI：1.54-3.52）到9次以上门诊和住院病人中的4.20（95% CI：2.74-6.44）。
结论：ACOS与肺栓塞（PE）的风险增加有关，尤其是在频发过敏性湿疹（AE-even）的年轻成人或者或无合并症的患者中。
（苏欣 审校）
PLoS One. 2016 Sep 9;11(9):e0162483. doi: 10.1371/journal.pone.0162483. eCollection 2016.
Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome Associated with Risk of Pulmonary Embolism.
Yeh JJ1,2,3, Wang YC4,5, Kao CH6,7,8.
Author information
Abstract
PURPOSE:We conducted a cohort study to clarify this relationship between asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) and pulmonary embolism (PE).
METHODS:From the National Health Insurance Research Database of Taiwan, we identified patients who had a diagnosis of asthma and a diagnosis of COPD (defined as ACOS) and concurrent treatment between January 1999 and December 2009 (ACOS cohort: n = 14,150; non-ACOS cohort: n = 55,876). Cox proportional hazards regression analysis was performed to determine the adjusted hazard ratios (aHRs) for PE of the ACOS cohort compared with the non-ACOS cohort.
RESULTS:Comparing the ACOS cohort with the non-ACOS cohort, the aHR of PE was 2.08 (95% confidence intervals [CIs]: 1.56-2.76). The risk of PE was higher in ACOS cohort than non-ACOS cohort, regardless of age, sex, comorbidity, inhaled corticosteroids (ICSs) and oral steroids (OSs) used. For ages ranging from 20 to 65 years, the aHR of PE was 2.53 (95% CI: 1.44-4.44) in the ACOS cohort. ACOS patients using ICSs (aHR: 1.97, 95% CI: 1.29-3.01) or OSs (aHR: 1.97, 95% CI: 1.46-2.65), the risk of PE was higher than in the non-ACOS cohort. The risk of PE increased with the number of outpatient visits and hospitalizations necessitated, ranging from 2.32 (95% CI: 1.54-3.52) in patients having 3-9 visits to 4.20 (95% CI: 2.74-6.44) for those having >9 visits.
CONCLUSIONS:ACOS is associated with increased risk of PE, particularly patients with a high frequency of AE-even in young adults or people without comorbidities.
PLoS One. 2016 Sep 9;11(9):e0162483. doi: 10.1371/journal.pone.0162483. eCollection 2016.
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美国武装部队中哮喘相关性残疾流行病学：2007-2012
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青少年哮喘在风险健康和肥胖的关系中的性别差异
