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慢性阻塞性肺疾病(COPD)患者的晨间症状:影响、评估与管理。

COPD symptoms in the morning: impact, evaluation and management.

机构信息

Respiratory and Intensive Care Medicine, Cochin Hospital Group, AP-HP University Paris Descartes, Paris, France.

出版信息

Respir Res. 2013 Oct 21;14(1):112. doi: 10.1186/1465-9921-14-112.


DOI:10.1186/1465-9921-14-112
PMID:24143997
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3816156/
Abstract

Chronic obstructive pulmonary disease (COPD) symptoms in the morning, including dyspnea and sputum production, affect patients' quality of life and limit their ability to carry out even simple morning activities. It is now emerging that these symptoms are associated with increased risk of exacerbations and work absenteeism, suggesting that they have a more profound impact on patients than previously thought. The development of validated patient-reported outcome (PRO) questionnaires to capture patients' experience of COPD symptoms in the morning is, therefore, vital for establishing effective and comprehensive management strategies. Although it is well established that long-acting bronchodilators are effective in improving COPD symptoms, the limited available data on their impact on morning symptoms and activities have been obtained with non-validated PRO questionnaires. In this review, we discuss the impact of COPD symptoms in the morning and available tools used to evaluate them, and highlight specific gaps that need to be addressed to develop standardized instruments able to meet regulatory requirement. We also present available evidence on the effect of pharmacological therapies on morning symptoms.

摘要

慢性阻塞性肺疾病(COPD)的清晨症状,包括呼吸困难和咳痰,影响患者的生活质量,并限制了他们进行甚至简单的清晨活动的能力。现在出现的情况表明,这些症状与加重和旷工的风险增加有关,这表明它们对患者的影响比以前认为的更为深远。因此,开发经过验证的患者报告结局(PRO)问卷来捕捉患者在清晨的 COPD 症状体验对于制定有效和全面的管理策略至关重要。尽管长效支气管扩张剂在改善 COPD 症状方面的有效性已经得到证实,但关于它们对清晨症状和活动影响的有限可用数据是使用未经验证的 PRO 问卷获得的。在这篇综述中,我们讨论了 COPD 清晨症状的影响以及用于评估它们的工具,并强调了需要解决的具体差距,以开发能够满足监管要求的标准化工具。我们还介绍了关于药物治疗对清晨症状影响的现有证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f64f/3816156/8cf1a5df6e08/1465-9921-14-112-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f64f/3816156/81f5992282da/1465-9921-14-112-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f64f/3816156/8cf1a5df6e08/1465-9921-14-112-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f64f/3816156/81f5992282da/1465-9921-14-112-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f64f/3816156/8cf1a5df6e08/1465-9921-14-112-2.jpg

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本文引用的文献

[1]
Efficacy and safety of aclidinium bromide compared with placebo and tiotropium in patients with moderate-to-severe chronic obstructive pulmonary disease: results from a 6-week, randomized, controlled Phase IIIb study.

COPD. 2013-7-2

[2]
Dual bronchodilation with QVA149 versus single bronchodilator therapy: the SHINE study.

Eur Respir J. 2013-5-30

[3]
Patient's perception of symptoms related to morning activity in chronic obstructive pulmonary disease: the SYMBOL Study.

Korean J Intern Med. 2012-11-27

[4]
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Eur Respir J. 2012-7-26

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Int J Chron Obstruct Pulmon Dis. 2012-7-31

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Eur Respir J. 2012-3-22

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COPD. 2012-2-9

[9]
A cross-sectional observational study to investigate daily symptom variability, effects of symptom on morning activities and therapeutic expectations of patients and physicians in COPD-SUNRISE study.

Tuberk Toraks. 2011

[10]
Efficacy and safety of once-daily NVA237 in patients with moderate-to-severe COPD: the GLOW1 trial.

Respir Res. 2011-12-7

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