Spanish Centre for Pharmacoepidemiological Research (CEIFE), Madrid, 28004, Spain.
COPD. 2009 Oct;6(5):369-79. doi: 10.1080/15412550903156325.
We evaluated the association of chronic obstructive pulmonary disease (COPD) with modifiable risk factors such as smoking and prescription medications, and investigated possible risk factors unique to patients who had never smoked. The UK General Practice Research Database was used to identify a cohort of patients with a first diagnosis of COPD (n = 1927) along with age- and sex-matched controls without COPD (n = 16 546). The incidence of COPD diagnoses and the risks associated with medication use, co-morbidities, and demographic factors, were estimated. The incidence of COPD was 2.6 per 1000 person-years (95% confidence interval [CI]: 2.5-2.7) among 40-89 year-olds. The risk significantly increased in current and former smokers (OR: 6.15 [95% CI: 5.41-7.00] and 3.45 [95% CI: 2.96-4.02]), respectively. The risk was significantly lower in former smokers than current smokers (OR: 0.61; 95% CI: 0.52-0.71). Current statin use was significantly associated with a reduced risk (OR: 0.45; 95% CI: 0.25-0.80). In never smokers, risk factors included advanced age and obesity. The risk in never smokers was more strongly related to paracetamol use (OR: 1.82; 95% CI: 1.33-2.49) than in current and former smokers (OR: 1.48; 95% CI: 1.18-1.86). In summary, COPD is associated with a range of cardiovascular and respiratory conditions and the risk is influenced by current and past medications. While the risk factors are similar in smokers and never smokers, some were unique to never smokers. Moreover, subjects who stopped smoking had a substantially lower COPD risk than those who continued smoking.
我们评估了慢性阻塞性肺疾病（COPD）与可改变的风险因素（如吸烟和处方药物）的关联，并研究了从未吸烟的患者特有的潜在风险因素。使用英国普通实践研究数据库确定了一组首次诊断为 COPD 的患者（n = 1927）以及年龄和性别匹配的无 COPD 对照组（n = 16546）。估计了 COPD 诊断的发生率以及与药物使用、合并症和人口统计学因素相关的风险。40-89 岁患者 COPD 的发病率为 2.6/1000 人年（95%置信区间[CI]：2.5-2.7）。目前和曾经吸烟者的风险显著增加（比值比[OR]：6.15 [95%CI：5.41-7.00]和 3.45 [95%CI：2.96-4.02]）。与当前吸烟者相比，前吸烟者的风险显著降低（OR：0.61；95%CI：0.52-0.71）。目前使用他汀类药物与降低风险显著相关（OR：0.45；95%CI：0.25-0.80）。在从不吸烟者中，风险因素包括年龄较大和肥胖。从不吸烟者的风险与对乙酰氨基酚的使用（OR：1.82；95%CI：1.33-2.49）比与当前和曾经吸烟者的使用（OR：1.48；95%CI：1.18-1.86）更密切相关。总之，COPD 与一系列心血管和呼吸系统疾病相关，且风险受当前和过去用药的影响。虽然吸烟者和从不吸烟者的风险因素相似，但有些因素是从不吸烟者特有的。此外，停止吸烟的受试者的 COPD 风险明显低于继续吸烟的受试者。
