Hurst J R, Donaldson G C, Wilkinson T M A, Perera W R, Wedzicha J A
Academic Unit of Respiratory Medicine, Royal Free and University College Medical School, Hampstead, London, NW3 2QG, UK.
Eur Respir J. 2005 Nov;26(5):846-52. doi: 10.1183/09031936.05.00043405.
Higher exacerbation incidence rates in chronic obstructive pulmonary disease (COPD) are associated with more rapid decline in lung function and poorer quality of life, yet the mechanisms determining susceptibility to exacerbation remain ill-defined. The same viruses responsible for common colds are frequently isolated during exacerbations. The current authors hypothesised that exacerbation frequency may be associated with an increased frequency of colds, and investigated whether increased exacerbation frequency was associated with increased acquisition of colds, or a greater likelihood of exacerbation once a cold has been acquired. A total of 150 patients with COPD completed diary cards recording peak expiratory flow, and respiratory and coryzal symptoms for a median 1,047 days. Annual cold and exacerbation incidence rates (cold and exacerbation frequency) were calculated, and the relationships between these variables were investigated. This analysis is based on 1,005 colds and 1,493 exacerbations. Frequent exacerbators (i.e. those whose exacerbation frequency was greater than the median) experienced significantly more colds than infrequent exacerbators (1.73 versus 0.94.yr(-1)). The likelihood of exacerbation during a cold was unaffected by exacerbation frequency. Patients experiencing frequent colds had a significantly higher exposure to cigarette smoke (46 versus 33 pack-yrs). Exacerbation frequency in chronic obstructive pulmonary disease is associated with an increased frequency of acquiring the common cold, rather than an increased propensity to exacerbation once a cold has been acquired.
慢性阻塞性肺疾病（COPD）中较高的急性加重发生率与肺功能更快下降和生活质量较差相关，但决定易感性的机制仍不明确。在急性加重期间经常分离出导致普通感冒的相同病毒。作者推测急性加重频率可能与感冒频率增加有关，并研究急性加重频率增加是否与感冒感染增加有关，或者一旦感染感冒，急性加重的可能性是否更大。共有150例COPD患者完成了日记卡，记录呼气峰值流速以及呼吸和鼻症状，为期中位数1047天。计算年度感冒和急性加重发生率（感冒和急性加重频率），并研究这些变量之间的关系。该分析基于1005次感冒和1493次急性加重。频繁急性加重者（即急性加重频率大于中位数的患者）比不频繁急性加重者经历更多感冒（1.73次/年对0.94次/年）。感冒期间急性加重的可能性不受急性加重频率的影响。经常感冒的患者接触香烟烟雾的时间明显更长（46包年对33包年）。慢性阻塞性肺疾病的急性加重频率与患普通感冒的频率增加有关，而不是一旦感染感冒，急性加重的倾向增加。
