哮喘联盟

    背景：流行病学研究显示，COPD患者慢性咳嗽和咳痰与死亡率的增加和疾病的进展有相关性。本研究的目的是找出COPD患者慢性咳嗽和咳痰有关的特异性特征。
    方法：选择COPD患者进行一项多中心队列研究（数据来源于法国17所大学医院）。我们对这些数据进行横断面分析。研究对象有433名COPD患者 (年龄65±11岁; FEV1, 50±20%预计值)。对伴有咳嗽、咳痰症状(n = 321)的和不伴上述症状(n = 112)的COPD患者进行比较。
    结果：结果显示，两组间年龄、FEV1、体重指数和并发症上无显著性差异。伴有慢性咳嗽、咳痰的COPD患者每人每年急性加重的总平均次数(分别为2.20±2.20和0.97±1.19；P<0.0001)、中度加重次数(分别为1.80±2.07和0.66±0.85；P<0.0001)和严重加重需住院治疗的次数(分别为0.43±0.95和0.22±0.56；P<0.02)均较不伴上述症状者明显增加。每位患者每年疾病加重总次数是唯一的与慢性咳嗽、咳痰有关的独立变量。伴有咳嗽、咳痰和不伴上述症状的患者分别有55％和22％的患者出现2次以上的急性加重(每年每位患者≥2次)(P<0.0001)。慢性咳嗽、咳痰和FEV1下降是与疾病频繁加重和频繁住院有关的独立相关因素。
    结论：慢性咳嗽和咳痰与COPD频繁加重有关，其中包括需要住院治疗的严重加重。

（苏楠 审校）
Burgel PR, et al. Chest. 2008 Nov 18. [Epub ahead of print]

Cough and Sputum Production Are Associated With Frequent Exacerbations and Hospitalizations in COPD Subjects.

Burgel PR, Nesme-Meyer P, Chanez P, et al. Chest. 2008 Nov 18. [Epub ahead of print]

Background: Epidemiologic studies indicate that chronic cough and sputum production are associated with increased mortality and disease progression in COPD subjects. Our objective was to identify features associated with chronic cough and sputum production in COPD subjects.
Methods: Cross-sectional analysis of data were obtained in a multicenter (17 university hospitals in France) cohort of COPD patients. The cohort comprised 433 COPD subjects (65 +/- 11 years; FEV(1), 50 +/- 20% predicted). Subjects with (n = 321) and without (n = 112) chronic cough and sputum production were compared.
Results: No significant difference was observed between groups for age, FEV(1), body mass index, and comorbidities. Subjects with chronic cough and sputum production had increased total mean numbers of exacerbations per patient per year (2.20 +/- 2.20 vs 0.97 +/- 1.19, respectively; p < 0.0001), moderate exacerbations (1.80 +/- 2.07 vs 0.66 +/- 0.85, respectively; p < 0.0001), and severe exacerbations requiring hospitalizations (0.43 +/- 0.95 vs 0.22 +/- 0.56, respectively; p < 0.02). the total number of exacerbations per patient per year was the only variable independently associated with chronic cough and sputum production. Frequent exacerbations (two or more per patients per year) occurred in 55% vs 22% of subjects, respectively, with and without chronic cough and sputum production (p < 0.0001). Chronic cough and sputum production and decreased FEV(1) were independently associated with an increased risk of frequent exacerbations and frequent hospitalizations.
Conclusions: Chronic cough and sputum production are associated with frequent COPD exacerbations, including severe exacerbations requiring hospitalizations.