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Granzyme B May Act as an Effector Molecule to Control the Inflammatory Process in COPD. Granzyme B 可作为一种效应分子控制慢性阻塞性肺病的炎症过程。
IF 2.2 4区 医学 Q3 Medicine Pub Date : 2024-12-01 Epub Date: 2024-02-05 DOI: 10.1080/15412555.2023.2299104
Won-Dong Kim, Don D Sin

Chronic obstructive pulmonary disease (COPD) is caused by smoking, but only a small proportion of smokers have disease severe enough to develop COPD. COPD is not always progressive. The question then arises as to what explains the different trajectories of COPD. The role of autoimmunity and regulatory T (Treg) cells in the pathogenesis of COPD is increasingly being recognized. Nine published studies on Treg cells in the lung tissue or bronchoalveolar lavage fluid have shown that smokers with COPD have fewer Treg cells than smokers without COPD or nonsmokers. Three studies showed a positive correlation between Treg cell count and FEV1%, suggesting an important role for Treg cells in COPD progression. Treg cells can regulate immunological responses via the granzyme B (GzmB) pathway. Immunohistochemical staining for GzmB in surgically resected lungs with centrilobular emphysema showed that the relationship between the amount of GzmB+ cells and FEV1% was comparable to that between Treg cell count and FEV1% in the COPD lung, suggesting that GzmB could be a functional marker for Treg cells. The volume fraction of GzmB+  cells in the small airways, the number of alveolar GzmB+ cells, and GzmB expression measured by enzyme-linked immunosorbent assay in the lung tissue of smokers were significantly correlated with FEV1%. These results suggest that the GzmB content in lung tissue may determine the progression of COPD by acting as an effector molecule to control inflammatory process. Interventions to augment GzmB-producing immunosuppressive cells in the early stages of COPD could help prevent or delay COPD progression.

慢性阻塞性肺病(COPD)是由吸烟引起的,但只有一小部分吸烟者的病情严重到会发展成慢性阻塞性肺病。慢性阻塞性肺病并不总是渐进的。那么问题来了,是什么解释了慢性阻塞性肺病的不同发展轨迹?自身免疫和调节性 T(Treg)细胞在慢性阻塞性肺病发病机制中的作用正日益得到认可。已发表的九项关于肺组织或支气管肺泡灌洗液中 Treg 细胞的研究表明,与无慢性阻塞性肺病的吸烟者或非吸烟者相比,患有慢性阻塞性肺病的吸烟者体内 Treg 细胞较少。三项研究显示,Treg 细胞数量与 FEV1% 呈正相关,这表明 Treg 细胞在慢性阻塞性肺病的发展过程中扮演着重要角色。Treg细胞可通过颗粒酶B(GzmB)途径调节免疫反应。对手术切除的中心叶肺气肿患者的肺进行GzmB免疫组化染色显示,GzmB+细胞数量与FEV1%之间的关系与COPD肺中Treg细胞数量与FEV1%之间的关系相当,这表明GzmB可能是Treg细胞的功能标志物。小气道中 GzmB+ 细胞的体积分数、肺泡中 GzmB+ 细胞的数量以及用酶联免疫吸附法测定的吸烟者肺组织中 GzmB 的表达均与 FEV1% 显著相关。这些结果表明,肺组织中的 GzmB 含量可作为控制炎症过程的效应分子,从而决定慢性阻塞性肺病的进展。在慢性阻塞性肺病的早期阶段对产生 GzmB 的免疫抑制细胞进行干预,有助于预防或延缓慢性阻塞性肺病的进展。
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引用次数: 0
The Role of Bioactive Small Molecules in COPD Pathogenesis. 生物活性小分子在慢性阻塞性肺病发病机制中的作用
IF 2.2 4区 医学 Q3 Medicine Pub Date : 2024-12-01 Epub Date: 2024-02-08 DOI: 10.1080/15412555.2024.2307618
Sha Liao, Yahong Chen

Chronic obstructive pulmonary disease (COPD) is recognized as a predominant contributor to mortality worldwide, which causes significant burdens to both society and individuals. Given the limited treatment options for COPD, there lies a critical realization: the imperative for expeditious development of novel therapeutic modalities that can effectively alleviate disease progression and enhance the quality of life experienced by COPD patients. Within the intricate field of COPD pathogenesis, an assortment of biologically active small molecules, encompassing small protein molecules and their derivatives, assumes crucial roles through diverse mechanisms. These mechanisms relate to the regulation of redox balance, the inhibition of the release of inflammatory mediators, and the modulation of cellular functions. Therefore, the present article aims to explore and elucidate the distinct roles played by different categories of biologically active small molecules in contributing to the pathogenesis of COPD.

慢性阻塞性肺疾病(COPD)被认为是导致全球死亡的主要因素,给社会和个人都造成了沉重负担。鉴于慢性阻塞性肺病的治疗方案有限,人们必须清醒地认识到:当务之急是尽快开发新型治疗方法,以有效缓解疾病进展,提高慢性阻塞性肺病患者的生活质量。在慢性阻塞性肺病错综复杂的发病机制中,各种具有生物活性的小分子(包括小蛋白分子及其衍生物)通过不同的机制发挥着至关重要的作用。这些机制涉及氧化还原平衡的调节、炎症介质释放的抑制以及细胞功能的调节。因此,本文旨在探讨和阐明不同类别的生物活性小分子在慢性阻塞性肺病发病机制中发挥的不同作用。
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引用次数: 0
Beclometasone Dipropionate/Formoterol Fumarate is Similarly Effective to Budesonide/Formoterol Fumarate in Chinese Patients with COPD: The FORSYYN Double-Blind, Randomised Study. 在中国慢性阻塞性肺病患者中,二丙酸倍氯米松/富马酸福莫特罗与布地奈德/富马酸福莫特罗疗效相似:FORSYYN 双盲随机研究。
IF 2.2 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2024-12-01 Epub Date: 2024-11-11 DOI: 10.1080/15412555.2024.2425157
Fuqiang Wen, Yanmin Wu, Chunyan Xing, Yingqun Zhu, Yongxing Chen, Xiaodong Mei, Massimo Corradi, Glauco Cappellini, Emanuele Calabro, Sergio Amodio, Cissy Zhu, Dmitry Galkin

The fixed-dose combination of beclometasone dipropionate/formoterol fumarate (BDP/FF) delivered via pressurised metered-dose inhaler (pMDI) has demonstrated efficacy in chronic obstructive pulmonary disease (COPD), in studies predominantly conducted in Caucasian adults. The current study evaluated the efficacy and safety of BDP/FF pMDI in Chinese patients with COPD, as part of registration for COPD in China. This double-blind, double-dummy, randomised, parallel-group study was conducted in patients with COPD of Chinese ethnicity aged ≥40 years. After a 4-week open-label budesonide/formoterol fumarate (BUD/FF) run-in period, patients were randomised to BUD/FF or BDP/FF for 24 weeks. The primary objective was to demonstrate non-inferiority of BDP/FF to BUD/FF in terms of change from baseline in pre-dose morning forced expiratory volume in 1 sec (FEV1) at Week 24 (i.e. the lower 95% CI limit of the difference was above the pre-defined non-inferiority margin of -0.07 L). Of 750 patients randomised (377 BDP/FF; 373 BUD/FF), 87.6% completed the study. The primary endpoint was met in both the per-protocol (adjusted mean difference -0.001 L [95% CI: -0.025, 0.022], non-inferiority p < 0.001) and intention-to-treat populations (-0.001 L [-0.024, 0.022]; non-inferiority p < 0.001). There were no statistically significant BDP/FF-BUD/FF differences for the secondary endpoints, and a similar proportion of patients had adverse events (BDP/FF, 51.7%; BUD/FF, 51.2%), with most mild/moderate in severity. In conclusion, BDP/FF pMDI was non-inferior to BUD/FF in terms of pre-dose morning FEV1, supported by a range of secondary endpoints. Both treatments were similarly tolerated. The study supports the use of BDP/FF pMDI in Chinese patients with COPD.

Study registration: China Centre for Drug Evaluation (CTR20180475).

通过加压计量吸入器(pMDI)给药的固定剂量二丙酸倍氯米松/富马酸福莫特罗(BDP/FF)复方制剂在慢性阻塞性肺病(COPD)中的疗效已得到证实,这些研究主要是在白种成人中进行的。本研究评估了 BDP/FF pMDI 在中国慢性阻塞性肺病患者中的疗效和安全性,作为慢性阻塞性肺病在中国注册的一部分。这项双盲、双哑药、随机、平行组研究在年龄≥40 岁的中国慢性阻塞性肺病患者中进行。经过为期4周的布地奈德/富马酸福莫特罗(BUD/FF)开放标签试运行期后,患者被随机分配到BUD/FF或BDP/FF治疗24周。主要目标是证明在第24周时,BDP/FF与BUD/FF相比,在用药前晨起1秒用力呼气容积(FEV1)与基线相比的变化方面不存在劣效性(即差异的95% CI下限高于预先设定的-0.07 L的非劣效性边际)。在 750 名随机患者中(377 名 BDP/FF;373 名 BUD/FF),87.6% 的患者完成了研究。在一系列次要终点的支持下,两种方案均达到了主要终点(调整后的平均差异为-0.001升[95% CI:-0.025,0.022],非劣效性p p 1)。两种疗法的耐受性相似。该研究支持在中国慢性阻塞性肺病患者中使用 BDP/FF pMDI:研究注册:中国药品审评中心(CTR20180475)。
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引用次数: 0
Clinical Significance of Long Non-Coding RNA SNHG5 in the Diagnosis and Prognosis of Chronic Obstructive Pulmonary Disease. 长非编码 RNA SNHG5 在慢性阻塞性肺病诊断和预后中的临床意义
IF 2.2 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2024-12-01 Epub Date: 2024-07-08 DOI: 10.1080/15412555.2024.2363630
Xue-Ting Yao, Wen-Ping Feng, Zhi-Peng Gong, Xin-Peng Li

Chronic obstructive pulmonary disease (COPD) is preventable and requires early screening. The study aimed to examine the clinical values of long non-coding RNA (lncRNA) SNHG5 in COPD diagnosis and prognosis. Out of 160 COPD patients, 80 were in the stable stage and 80 were in the acute exacerbation of COPD stage (AECOPD). SNHG5 expression was detected via qRT-PCR. The survival analysis was conducted using Cox regression analysis and K-M curve. SNHG5 levels significantly reduced in both stable COPD and AECOPD groups compared with the control group, with AECOPD group recording the lowest values. SNHG5 levels were negatively correlated with GOLD stage. Serum SNHG5 can differentiate stable COPD patients from healthy individuals (AUC = 0.805), and can screen AECOPD from stable ones (AUC = 0.910). SNHG5 negatively influenced the release of inflammatory cytokines. For AECOPD patients, those with severe cough and wheezing dyspnea symptoms exhibited the lowest values of SNUG5. Among the 80 AECOPD patients, 16 cases died in the one-year follow-up, all of whom had low levels of SNHG5. SNHG5 levels independently influenced survival outcomes, patients with low SNHG5 levels had a poor prognosis. Thus, lncRNA SNHG5, which is downregulated in patients with COPD (especially AECOPD), can potentially protect against AECOPD and serve as a novel prognostic biomarker for AECOPD.

慢性阻塞性肺病(COPD)是可以预防的,需要早期筛查。该研究旨在探讨长非编码 RNA(lncRNA)SNHG5 在 COPD 诊断和预后中的临床价值。在160名慢性阻塞性肺病患者中,80人处于稳定期,80人处于慢性阻塞性肺病急性加重期(AECOPD)。通过 qRT-PCR 检测 SNHG5 的表达。采用Cox回归分析和K-M曲线进行生存分析。与对照组相比,稳定型慢性阻塞性肺病组和 AECOPD 组的 SNHG5 水平均明显下降,其中 AECOPD 组的 SNHG5 水平最低。SNHG5 水平与 GOLD 分期呈负相关。血清 SNHG5 可将稳定型 COPD 患者与健康人区分开来(AUC = 0.805),并可将 AECOPD 与稳定型患者区分开来(AUC = 0.910)。SNHG5 对炎症细胞因子的释放有负面影响。在 AECOPD 患者中,有严重咳嗽和喘息性呼吸困难症状的患者 SNUG5 值最低。在80名AECOPD患者中,有16人在一年的随访中死亡,他们的SNHG5水平都很低。SNHG5水平对生存结果有独立影响,SNHG5水平低的患者预后较差。因此,在慢性阻塞性肺病(尤其是AECOPD)患者中下调的lncRNA SNHG5有可能预防AECOPD,并可作为AECOPD的新型预后生物标志物。
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引用次数: 0
A Study on the Association between Cough Sensitivity and Acute Exacerbations in Patients with Chronic Obstructive Pulmonary Disease. 慢性阻塞性肺病患者咳嗽敏感性与急性加重之间的关系研究
IF 2.2 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2024-12-01 Epub Date: 2024-11-19 DOI: 10.1080/15412555.2024.2425153
Haodong Bai, Shuangxi Wang, Bingxian Sha, Xianghuai Xu, Li Yu

Objective: To investigate the relationship between cough sensitivity and acute exacerbation in stable chronic obstructive pulmonary disease (COPD) patients.

Methods: Stable COPD patients who visited our department from July 2022 to June 2023 were included. They were subjected to cough sensitivity test, spirometry, induced sputum cytology examination, questionnaire assessment such as cough symptom score, etc. They were followed up for 12 months, and were divided into the acute exacerbation (AE) group and the stable group according to whether acute exacerbation occurred during the follow-up period. We compared the differences in cough sensitivity, pulmonary function, and questionnaires between the two groups, analyzed the relationship between cough sensitivity and acute exacerbation, and screened the risk factors for AECOPD.

Results: A total of 145 patients with stable COPD were included. AE group (n = 94) had lower FEV1/FVC (50.08 ± 11.11 versus 54.28 ± 11.58, p = 0.03) and cough sensitivity lgC5 [-0.01(0.90) versus 0.59(0.90), p < 0.01] than those in the stable group (n = 51) patients, the daytime cough symptom score [2(2) versus 1(2), p = 0.02] and VAS score [50(40) versus 30(50), p < 0.01] were higher than stable group. Multivariate logistic regression analysis showed lgC5 (OR = 0.34, 95% CI = 0.16-0.71, p < 0.01) was an independent risk factor for AECOPD. When lgC5 was used to predict acute exacerbation in stable COPD patients, the AUC was 0.69, the sensitivity was 59.57%, and the specificity was 72.55%.

Conclusion: Although causality is not necessarily demonstrated, baseline cough sensitivity lgC5 in stable COPD patients is an independent risk factor for AECOPD, and it has some predictive value for future acute exacerbations.

目的:研究稳定期慢性阻塞性肺病(COPD)患者咳嗽敏感性与急性加重的关系:研究慢性阻塞性肺疾病(COPD)稳定期患者咳嗽敏感性与急性加重之间的关系:纳入 2022 年 7 月至 2023 年 6 月到我科就诊的稳定期慢性阻塞性肺疾病患者。对他们进行咳嗽敏感性测试、肺活量测定、诱导痰细胞学检查、咳嗽症状评分等问卷评估。随访12个月,根据随访期间是否发生急性加重分为急性加重(AE)组和稳定组。我们比较了两组患者在咳嗽敏感性、肺功能和问卷调查方面的差异,分析了咳嗽敏感性与急性加重之间的关系,并筛查了AECOPD的危险因素:结果:共纳入145名慢性阻塞性肺病稳定期患者。AE组(n = 94)患者的FEV1/FVC(50.08 ± 11.11对54.28 ± 11.58,p = 0.03)和咳嗽敏感性lgC5[-0.01(0.90)对0.59(0.90),p n = 51]较低,日间咳嗽症状评分[2(2)对1(2),p = 0.02]和 VAS 评分[50(40) 对 30(50),p 5(OR = 0.34,95% CI = 0.16-0.71,p 5)用于预测稳定期 COPD 患者的急性加重,AUC 为 0.69,敏感性为 59.57%,特异性为 72.55%:尽管不一定能证明因果关系,但稳定期慢性阻塞性肺病患者的基线咳嗽敏感性 lgC5 是 AECOPD 的一个独立危险因素,对未来急性加重有一定的预测价值。
{"title":"A Study on the Association between Cough Sensitivity and Acute Exacerbations in Patients with Chronic Obstructive Pulmonary Disease.","authors":"Haodong Bai, Shuangxi Wang, Bingxian Sha, Xianghuai Xu, Li Yu","doi":"10.1080/15412555.2024.2425153","DOIUrl":"10.1080/15412555.2024.2425153","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between cough sensitivity and acute exacerbation in stable chronic obstructive pulmonary disease (COPD) patients.</p><p><strong>Methods: </strong>Stable COPD patients who visited our department from July 2022 to June 2023 were included. They were subjected to cough sensitivity test, spirometry, induced sputum cytology examination, questionnaire assessment such as cough symptom score, etc. They were followed up for 12 months, and were divided into the acute exacerbation (AE) group and the stable group according to whether acute exacerbation occurred during the follow-up period. We compared the differences in cough sensitivity, pulmonary function, and questionnaires between the two groups, analyzed the relationship between cough sensitivity and acute exacerbation, and screened the risk factors for AECOPD.</p><p><strong>Results: </strong>A total of 145 patients with stable COPD were included. AE group (<i>n</i> = 94) had lower FEV<sub>1</sub>/FVC (50.08 ± 11.11 <i>versus</i> 54.28 ± 11.58, <i>p</i> = 0.03) and cough sensitivity lgC<sub>5</sub> [-0.01(0.90) <i>versus</i> 0.59(0.90), <i>p</i> < 0.01] than those in the stable group (<i>n</i> = 51) patients, the daytime cough symptom score [2(2) <i>versus</i> 1(2), <i>p</i> = 0.02] and VAS score [50(40) <i>versus</i> 30(50), <i>p</i> < 0.01] were higher than stable group. Multivariate logistic regression analysis showed lgC<sub>5</sub> (<i>OR</i> = 0.34, 95% <i>CI</i> = 0.16-0.71, <i>p</i> < 0.01) was an independent risk factor for AECOPD. When lgC<sub>5</sub> was used to predict acute exacerbation in stable COPD patients, the AUC was 0.69, the sensitivity was 59.57%, and the specificity was 72.55%.</p><p><strong>Conclusion: </strong>Although causality is not necessarily demonstrated, baseline cough sensitivity lgC<sub>5</sub> in stable COPD patients is an independent risk factor for AECOPD, and it has some predictive value for future acute exacerbations.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"21 1","pages":"2425153"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing the Causal Role of Walking Pace and Hand Grip Strength with Chronic Obstructive Pulmonary Disease Hospital: A Mendelian Randomization Study. 在慢性阻塞性肺疾病医院评估步行速度和握力的因果作用:孟德尔随机研究。
IF 2.2 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2024-12-01 Epub Date: 2024-12-02 DOI: 10.1080/15412555.2024.2427737
Lu Wang, Xiaomin Wang, Dong Chen

Background: Chronic obstructive pulmonary disease(COPD) hospitalization heightens risks for patients, including mortality, reduced quality of life, and financial strain. Walking pace (WP) and hand grip strength (HGS) are key indicators, their direct connection to COPD hospitalization is uncertain.

Objective: To investigate the relationship between genetic determinants of walking pace, hand grip strength, and the risk of COPD hospitalization as well as lung function.

Methods: The data pertaining to WP (n = 459,915), HGS (n = 922,115), COPD hospitalizations (n = 309,154), and lung function (n = 79,055) were procured from comprehensive large-scale genome-wide association studies. In carrying out the causal inference analysis, robust statistical methods were utilized, encompassing inverse variance weighted (IVW), MR-Egger, weighted median, simple median and Weighted mode. To address issues of heterogeneity, pleiotropy, and outliers, we incorporated sensitivity analyses and Mendelian randomization (MR) techniques.

Results: The IVW analysis suggests that a faster WP reduces the risk of COPD hospitalization (OR = 0.3559, 95% CI: 0.22-0.52; p = 5.197 × 10-5). It also reveals a potential association between gait speed and the likelihood of developing early-onset COPD (OR = 0.189, 95% CI 0.09 to 0.39; p = 8.89 × 10-6) as well as late-onset COPD (OR = 0.44, 95% CI 0.25 to 0.76; p = 0.0036). The IVW analysis further indicates a potential correlation between an increased WP and enhanced peak expiratory flow (PEF) (OR = 1.699, 95% CI: 1.23 to 2.35; p = 0.0014), forced expiratory volume in 1 s(FEV1, OR = 1.557, 95% CI 1.24 to 1.95; p = 0.0001), and forced vital capacity(FVC, OR = 1.584, 95% CI 1.26 to 1.99; p = 8.89 × 10-5). The IVW analysis suggests a possible causal link between stronger left-hand grip strength and elevated levels of FVC (OR = 1.29, 95% CI: 1.15 to 1.46; p = 1.68 × 10-5), FEV1 (OR = 1.24, 95% CI: 1.11 to 1.39; p = 1.63 × 10-4), and PEF (OR = 1.2, 95% CI: 1.07 to 1.36; p = 2.67 × 10-3). Similarly, right-hand grip strength exhibits a comparable causal relationship with FVC and PEF as left-hand grip strength.

Conclusions: Our research shows a link between slower walking pace and higher COPD hospitalization risk, as well as decreased lung function (PEF, FEV1, FVC). We also found a significant correlation between weaker hand grip and reduced lung function, especially FVC. These findings have the potential to improve risk assessment approaches, intervention strategies, and management methods for COPD patients, while simultaneously enhancing their overall quality of life and health status.

背景:慢性阻塞性肺疾病(COPD)住院会增加患者的风险,包括死亡率、生活质量下降和经济压力。步行速度(WP)和手握力(HGS)是关键指标,其与COPD住院的直接关系尚不确定。目的:探讨步行速度、握力、COPD住院风险及肺功能的遗传决定因素之间的关系。方法:从全面的大规模全基因组关联研究中获得与WP (n = 459,915)、HGS (n = 922,115)、COPD住院(n = 309,154)和肺功能(n = 79,055)相关的数据。在进行因果推理分析时,使用了稳健的统计方法,包括逆方差加权(IVW)、MR-Egger、加权中位数、简单中位数和加权模型。为了解决异质性、多效性和异常值的问题,我们结合了敏感性分析和孟德尔随机化(MR)技术。结果:IVW分析显示,更快的WP可降低COPD住院的风险(OR = 0.3559, 95% CI: 0.22-0.52;p = 5.197 × 10-5)。它还揭示了步态速度与发生早发性COPD的可能性之间的潜在关联(OR = 0.189, 95% CI 0.09至0.39;p = 8.89 × 10-6)以及晚发型COPD (OR = 0.44, 95% CI 0.25 ~ 0.76;p = 0.0036)。IVW分析进一步表明,WP增加与呼气峰流量(PEF)增强之间存在潜在的相关性(OR = 1.699, 95% CI: 1.23 ~ 2.35;p = 0.0014), 1 s内用力呼气量(FEV1, OR = 1.557, 95% CI 1.24 ~ 1.95;p = 0.0001)和强迫肺活量(FVC, OR = 1.584, 95% CI 1.26 ~ 1.99;p = 8.89 × 10-5)。IVW分析表明,左手握力较强与FVC水平升高之间可能存在因果关系(OR = 1.29, 95% CI: 1.15至1.46;p = 1.68×纯)、FEV1 (OR = 1.24, 95% CI: 1.11 - 1.39;p = 1.63×身手),尤其和PEF (OR = 1.2, 95% CI: 1.07 - 1.36;p = 2.67 × 10-3)。同样,右手握力与FVC和PEF的因果关系与左手握力的因果关系相似。结论:我们的研究表明,步行速度较慢与COPD住院风险较高以及肺功能(PEF、FEV1、FVC)下降有关。我们还发现,握力较弱与肺功能(尤其是肺活量)降低之间存在显著相关性。这些发现有可能改善COPD患者的风险评估方法、干预策略和管理方法,同时提高他们的整体生活质量和健康状况。
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引用次数: 0
The Application of Self-Made Disseminating and Descending Breathing Exercises in Home Rehabilitation of Stable COPD. 自制发散式和下降式呼吸练习在稳定型慢性阻塞性肺疾病家庭康复中的应用。
IF 2.2 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2024-12-01 Epub Date: 2024-08-01 DOI: 10.1080/15412555.2024.2369541
Ling-Xiu Chen, Shu-Lei Peng, Liang-Ping Mao, Xin-Wei Luo, Qian He, Jian-Hua Xiang, Fu-Juan Long, Yan Jiao

To investigate the clinical effects and application value of self-made disseminating and descending breathing exercises on home rehabilitation of patients with stable chronic obstructive pulmonary disease (COPD). Seeking to generate concepts for creating novel, convenient, and efficient COPD prognosis rehabilitation exercises aimed at enhancing the well-being and rehabilitation confidence of both COPD patients and their families. A total of 70 COPD patients admitted to our outpatient department from July 2019 to September 2021 were randomly divided into the exercise group (n = 35) and the control group (n = 35). The control group received routine breathing training, while the exercise group was treated with self-made disseminating and descending breathing exercises. The respiratory function, including pulmonary function (FVC, FEV1, FEV1/FVC) and respiratory muscle strength (MIP, MEP), exercise tolerance (6-min walking distance, 6MWT), Modified Medical Research Council Dyspnea Scale (mMRC, Borg), COPD quality of life score (CAT, SGRQ), anxiety and depression scores (HAMA, HAMD) were compared between the two groups after 12-week exercise. After 12-week training, the FEV1, MIP, and MEP in the exercise group were significantly higher than those in the control group (p < 0.001), and the 6MWT was significantly increased in the exercise group compared to the control group (p < 0.001); while the mMRC, Borg score, the scores of CAT, SGRQ, HAMA, and HAMD were found significantly lower than those in the control group (p < 0.001). The self-made disseminating and descending breathing exercises can improve respiratory function and reduce symptoms of dyspnea in COPD patients, while enhancing exercise tolerance and relieving anxiety and depression, and are worthy of clinical application.

探究自制散发式和下降式呼吸操对慢性阻塞性肺疾病(COPD)稳定期患者家庭康复的临床效果和应用价值。寻求创建新颖、便捷、高效的慢性阻塞性肺疾病预后康复训练的概念,旨在提高慢性阻塞性肺疾病患者及其家属的幸福感和康复信心。2019年7月至2021年9月,我院门诊部共收治70名慢性阻塞性肺疾病患者,随机分为运动组(n = 35)和对照组(n = 35)。对照组接受常规呼吸训练,而运动组则接受自制的发散式和下降式呼吸训练。运动 12 周后,比较两组患者的呼吸功能,包括肺功能(FVC、FEV1、FEV1/FVC)和呼吸肌力量(MIP、MEP)、运动耐量(6 分钟步行距离,6MWT)、改良医学研究委员会呼吸困难量表(mMRC、Borg)、COPD 生活质量评分(CAT、SGRQ)、焦虑和抑郁评分(HAMA、HAMD)。经过 12 周训练后,运动组的 FEV1、MIP 和 MEP 均明显高于对照组(P P P
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引用次数: 0
Risk Factors for Adults with Chronic Obstructive Pulmonary Disease in the United States, Utilizing State-Based Surveillance. 美国成人慢性阻塞性肺病患者的风险因素,利用基于州的监测。
IF 2.2 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2024-12-01 Epub Date: 2024-10-11 DOI: 10.1080/15412555.2024.2413712
Brandon Workman, Laura Nabors

Chronic Obstructive Pulmonary Disease (COPD) is a complex and heterogeneous condition. Exposure to tobacco smoke and air pollutants are key risk factors for COPD development; however, other risk factors include race/ethnicity, sex of adults, a history of asthma, occupational exposures, and chronic respiratory infections. Data for the current study were from the 2022 Behavioral Risk Factor Surveillance Survey. Chi-squares and multinomial logistic regression analyses, adjusted with the survey's sampling weight, were used to examine how critical health indicators impacted a COPD diagnosis. Participants (N = 311,175) were adults aged 45 years and older. Adjusted multinomial regression analyses showed adults who reported asthma, current and former smoking, poor physical health, depression, less physical activity, and fatigue were more likely to report COPD. Those with COPD were more likely to be male than female. Moreover, those with COPD reported higher rates of health insurance coverage, and yet had lower income and more financial difficulty affording a doctor for health services. In a follow up regression analysis, examining racial differences in COPD for participants, American Indian adults had a higher odds of reporting COPD than the "other" race groups. Because COPD remains a leading cause of death and disability in the U.S., and racial disparities persist in respiratory outcomes, continuing to identify risk factors for vulnerable groups could assist health program planners with development of successful health messaging.

慢性阻塞性肺病(COPD)是一种复杂的异质性疾病。接触烟草烟雾和空气污染物是慢性阻塞性肺病发病的主要风险因素;然而,其他风险因素还包括种族/民族、成人性别、哮喘病史、职业接触和慢性呼吸道感染。本研究的数据来自 2022 年行为风险因素监测调查。利用经调查抽样权重调整后的卡方和多项式逻辑回归分析来研究关键健康指标对慢性阻塞性肺病诊断的影响。参与者(N = 311,175 人)均为 45 岁及以上的成年人。调整后的多项式回归分析表明,报告患有哮喘、目前或曾经吸烟、身体健康状况不佳、抑郁、体力活动较少和疲劳的成年人更有可能报告患有慢性阻塞性肺病。慢性阻塞性肺病患者中男性多于女性。此外,慢性阻塞性肺病患者的医疗保险覆盖率较高,但他们的收入较低,在支付医生的医疗服务费用方面有更大的经济困难。在后续回归分析中,研究人员对慢性阻塞性肺病的种族差异进行了研究,结果显示,美国印第安人报告患有慢性阻塞性肺病的几率高于 "其他 "种族群体。由于慢性阻塞性肺病仍然是导致美国人死亡和残疾的主要原因,而且在呼吸系统疾病的治疗结果方面仍然存在种族差异,因此继续识别弱势群体的风险因素可以帮助健康项目规划者开发成功的健康信息。
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引用次数: 0
Proposal for a 4-Level Classification System of Severe COPD Exacerbation According to Healthcare Resource Utilization. 根据医疗资源使用情况建立严重慢性阻塞性肺疾病恶化四级分类系统的建议。
IF 2.2 4区 医学 Q3 Medicine Pub Date : 2024-12-01 Epub Date: 2024-05-28 DOI: 10.1080/15412555.2024.2358097
Georgios Hillas, Stelios Loukides, Athena Gogali, Konstantinos Kostikas
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引用次数: 0
Guidelines for the Pharmacologic Treatment of COPD 2023: Canada versus GOLD. 慢性阻塞性肺疾病药物治疗指南 2023》:加拿大与 GOLD。
IF 2.2 4区 医学 Q3 Medicine Pub Date : 2024-12-01 Epub Date: 2024-02-08 DOI: 10.1080/15412555.2023.2292613
Samy Suissa
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引用次数: 0
期刊
COPD: Journal of Chronic Obstructive Pulmonary Disease
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