Centre for Respiratory Medicine, UCL Medical School, Royal Free Campus, Rowland Hill Street Hampstead, London NW3 2PF, UK.
Respir Res. 2013 Jul 30;14(1):79. doi: 10.1186/1465-9921-14-79.
Patients with chronic obstructive pulmonary disease (COPD) can be categorized as having frequent (FE) or infrequent (IE) exacerbations depending on whether they respectively experience two or more, or one or zero exacerbations per year. Although most patients do not change category from year to year, some will, and the factors associated with this behaviour have not been examined.
1832 patients completing two year follow-up in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points (ECLIPSE) study were examined at baseline and then yearly. Exacerbations were defined by health care utilisation. Patient characteristics compared between those patients who did or did not change exacerbation category from year 1 to year 2.
Between years 1 and 2, 221 patients (17%) changed from IE to FE and 210 patients (39%) from FE to IE. More severe disease was associated with changing from IE to FE and less severe disease from FE to IE. Over the preceding year, small falls in FEV1 and 6-minute walking distance were associated with changing from IE to FE, and small falls in platelet count associated with changing from FE to IE.
No parameter clearly predicts an imminent change in exacerbation frequency category.
SCO104960, clinicaltrials.gov identifier NCT00292552.
根据患者每年经历 2 次或以上或 1 次或 0 次加重的情况，可将慢性阻塞性肺疾病（COPD）患者分为频繁加重（FE）或不频繁加重（IE）。尽管大多数患者每年不会改变分类，但有些患者会，而与这种行为相关的因素尚未被研究。
在评估 COPD 患者纵向以确定预测替代终点（ECLIPSE）研究中，1832 例完成 2 年随访的患者在基线时以及每年接受检查。加重通过医疗保健利用来定义。在第 1 年至第 2 年期间，比较患者的特征，这些患者的加重类别从第 1 年到第 2 年发生了变化或没有变化。
在第 1 年至第 2 年之间，221 例（17%）患者从 IE 转为 FE，210 例（39%）患者从 FE 转为 IE。更严重的疾病与从 IE 转为 FE 有关，而从 FE 转为 IE 则与更严重的疾病有关。在前一年，FEV1 和 6 分钟步行距离的轻微下降与从 IE 转为 FE 有关，血小板计数的轻微下降与从 FE 转为 IE 有关。
没有明确的参数可以预测加重频率类别的变化。
SCO104960，临床试验标识符 NCT00292552。
