1Temple University School of Medicine , Philadelphia, PA , USA.
COPD. 2013 Dec;10(6):667-78. doi: 10.3109/15412555.2013.827166. Epub 2013 Aug 26.
Chronic bronchitis in COPD has been associated with an increased exacerbation rate, more hospitalizations, and an accelerated decline in lung function. The clinical characteristics of patients with advanced emphysema and chronic bronchitis have not been well described.
Patients randomized to medical therapy in the National Emphysema Treatment Trial were grouped based on their reports of cough and phlegm on the St. George's Respiratory Questionnaire(SGRQ) at baseline: chronic bronchitis(CB+) and no chronic bronchitis(CB-). The patients were similarly categorized into severe chronic bronchitis(SCB+) or no severe chronic bronchitis (SCB-) based on the above definition plus report of chest trouble. Kaplan-Meier survival analysis was used to determine the relationships between chronic bronchitis and severe chronic bronchitis and survival and time to hospitalization. Lung function and SGRQ scores over time were compared between groups.
The CB+(N = 234; 38%) and CB- groups(N = 376; 62%) had similar survival (median 60.8 versus 65.7 months, p = 0.19) and time to hospitalization (median 26.9 versus 24.9 months, p = 0.84). The SCB+ group(N = 74; 12%) had worse survival (median 47.7 versus 65.7 months, p = 0.02) and shorter time to hospitalization (median 18.5 versus 26.7 months, p = 0.02) than the SCB- group (N = 536; 88%). Mortality and hospitalization rates were not increased when chest trouble was analyzed by itself. The CB+ and CB-groups had similar lung function and SGRQ scores over time. The SCB+ and SCB-groups had similar lung function over time, but the SCB+ group had significantly worse SGRQ scores.
Severe chronic bronchitis is associated with worse survival, shorter time to hospitalization, and worse health-related quality of life.
慢性阻塞性肺疾病（COPD）中的慢性支气管炎与加重频率增加、更多住院和肺功能加速下降有关。晚期肺气肿和慢性支气管炎患者的临床特征尚未得到很好的描述。
在国家肺气肿治疗试验中随机分配至药物治疗的患者根据他们在基线时圣乔治呼吸问卷（SGRQ）上报告的咳嗽和咳痰情况进行分组：慢性支气管炎（CB+）和无慢性支气管炎（CB-）。患者根据上述定义加上胸部不适的报告同样分为严重慢性支气管炎（SCB+）或无严重慢性支气管炎（SCB-）。使用 Kaplan-Meier 生存分析来确定慢性支气管炎和严重慢性支气管炎与生存和住院时间之间的关系。比较各组之间随时间变化的肺功能和 SGRQ 评分。
CB+组（N=234；38%）和 CB-组（N=376；62%）的生存情况相似（中位时间 60.8 个月与 65.7 个月，p=0.19）和住院时间（中位时间 26.9 个月与 24.9 个月，p=0.84）。SCB+组（N=74；12%）的生存情况较差（中位时间 47.7 个月与 65.7 个月，p=0.02）和住院时间较短（中位时间 18.5 个月与 26.7 个月，p=0.02）比 SCB-组（N=536；88%）。当单独分析胸部不适时，死亡率和住院率没有增加。CB+和 CB-组的肺功能和 SGRQ 评分随时间变化相似。SCB+和 SCB-组的肺功能随时间变化相似，但 SCB+组的 SGRQ 评分明显较差。
严重慢性支气管炎与较差的生存、较短的住院时间和较差的健康相关生活质量相关。
