Department of Pulmonary and Critical Care Medicine & Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Int J Tuberc Lung Dis. 2010 Nov;14(11):1481-8.
Eleven referring hospitals in South Korea.
To classify the phenotypes in elderly subjects with obstructive lung disease (OLD).
We analysed 191 subjects aged ≥ 60 years with chronic respiratory symptoms and either obstructive spirometry or bronchial hyperresponsiveness. Factor analysis was performed using commonly measured variables and revealed four significant variables: 1) the ratio of inspiratory capacity to total lung capacity, 2) the total score on the St George's Respiratory Questionnaire, 3) the volume fraction of the lung less than 950 Hounsfield Unit at full inspiration on volumetric computed tomography and 4) post-bronchodilator forced expiratory volume in 1 second (FEV(1)) changes. We performed a cluster analysis on these four variables.
The mean age was 68.5 (± 5.2 SD) years and the mean post-bronchodilator FEV(1) was 52.4% (± 16.5) predicted. Three clusters with the following phenotypes were identified: Cluster 1 included subjects with moderate to severe airflow obstruction and bronchodilator reversibility; Cluster 2 subjects had moderate airflow obstruction without bronchodilator reversibility, and Cluster 3 subjects had severe airflow obstruction without bronchodilator reversibility.
We identified three phenotypes in elderly subjects with OLD. Follow-up studies are needed to explore the clinical significance of each phenotype.
韩国的 11 家指定医院。
对老年阻塞性肺疾病（OLD）患者的表型进行分类。
我们分析了 191 名年龄≥60 岁、有慢性呼吸系统症状且存在阻塞性肺功能检查或支气管高反应性的患者。使用常用测量变量进行因子分析，揭示了四个显著变量：1）吸气量与肺总量之比，2）圣乔治呼吸问卷总评分，3）全肺 CT 吸气时低于 950 亨氏单位的肺容积分数，4）支气管扩张剂后 1 秒用力呼气量（FEV1）变化。我们对这四个变量进行了聚类分析。
患者平均年龄为 68.5（±5.2 SD）岁，支气管扩张剂后 FEV1 平均为预测值的 52.4%（±16.5）。确定了三种具有以下表型的聚类：聚类 1 包括中重度气流阻塞和支气管扩张剂逆转的患者；聚类 2 患者有中度气流阻塞但无支气管扩张剂逆转，聚类 3 患者有严重气流阻塞但无支气管扩张剂逆转。
我们在老年 OLD 患者中确定了三种表型。需要进行随访研究以探讨每种表型的临床意义。
