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规律的体育活动可降低慢性阻塞性肺疾病患者的住院率和死亡率:一项基于人群的队列研究。

Regular physical activity reduces hospital admission and mortality in chronic obstructive pulmonary disease: a population based cohort study.

作者信息

Garcia-Aymerich J, Lange P, Benet M, Schnohr P, Antó J M

机构信息

Respiratory and Environmental Health Research Unit, Institut Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain.

出版信息

Thorax. 2006 Sep;61(9):772-8. doi: 10.1136/thx.2006.060145. Epub 2006 May 31.

Abstract

BACKGROUND

Information about the influence of regular physical activity on the course of chronic obstructive pulmonary disease (COPD) is scarce. A study was undertaken to examine the association between regular physical activity and both hospital admissions for COPD and all-cause and specific mortality in COPD subjects.

METHODS

From a population-based sample recruited in Copenhagen in 1981-3 and 1991-4, 2386 individuals with COPD (according to lung function tests) were identified and followed until 2000. Self-reported regular physical activity at baseline was classified into four categories (very low, low, moderate, and high). Dates and causes of hospital admissions and mortality were obtained from Danish registers. Adjusted associations between physical activity and hospital admissions for COPD and mortality were obtained using negative binomial and Cox regression models, respectively.

RESULTS

After adjustment for relevant confounders, subjects reporting low, moderate or high physical activity had a lower risk of hospital admission for COPD during the follow up period than those who reported very low physical activity (incidence rate ratio 0.72, 95% confidence interval (CI) 0.53 to 0.97). Low, moderate and high levels of regular physical activity were associated with an adjusted lower risk of all-cause mortality (hazard ratio (HR) 0.76, 95% CI 0.65 to 0.90) and respiratory mortality (HR 0.70, 95% CI 0.48 to 1.02). No effect modification was found for sex, age group, COPD severity, or a background of ischaemic heart disease.

CONCLUSIONS

Subjects with COPD who perform some level of regular physical activity have a lower risk of both COPD admissions and mortality. The recommendation that COPD patients be encouraged to maintain or increase their levels of regular physical activity should be considered in future COPD guidelines, since it is likely to result in a relevant public health benefit.

摘要

背景

关于规律体育活动对慢性阻塞性肺疾病(COPD)病程影响的信息匮乏。开展了一项研究以探讨规律体育活动与COPD患者的住院治疗以及全因死亡率和特定死亡率之间的关联。

方法

从1981 - 1983年和1991 - 1994年在哥本哈根招募的基于人群的样本中,识别出2386例患有COPD(根据肺功能测试)的个体,并随访至2000年。将基线时自我报告的规律体育活动分为四类(极低、低、中等和高)。住院日期和原因以及死亡率数据来自丹麦登记处。分别使用负二项回归模型和Cox回归模型获得体育活动与COPD住院治疗和死亡率之间的校正关联。

结果

在对相关混杂因素进行校正后,报告低、中等或高强度体育活动的受试者在随访期间因COPD住院的风险低于报告极低强度体育活动的受试者(发病率比0.七十二,95%置信区间(CI)0.五十三至0.九十七)。低、中和高强度的规律体育活动与校正后的全因死亡率较低风险(风险比(HR)0.七十六,95%CI 0.六十五至0.九十)和呼吸死亡率较低风险(HR 0.七十,95%CI 0.四十八至1.零二)相关。未发现性别、年龄组、COPD严重程度或缺血性心脏病背景对结果有影响。

结论

进行一定程度规律体育活动的COPD患者COPD住院和死亡风险较低。未来的COPD指南应考虑建议鼓励COPD患者维持或增加其规律体育活动水平,因为这可能会带来相关的公共卫生益处。

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