Pleasants Roy A, Ohar Jill A, Croft Janet B, Liu Yong, Kraft Monica, Mannino David M, Donohue James F, Herrick Harry L
1Campbell University College of Pharmacy and Health Sciences and Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University School of Medicine , Durham, NC , USA.
COPD. 2014 Jun;11(3):256-66. doi: 10.3109/15412555.2013.840571. Epub 2013 Oct 23.
Abstract Background: Persons with chronic obstructive pulmonary disease (COPD) and/or asthma have great risk for morbidity. There has been sparse state-specific surveillance data to estimate the impact of COPD or COPD with concomitant asthma (overlap syndrome) on health-related impairment.
The North Carolina (NC) Behavioral Risk Factor Surveillance System (BRFSS) was used to assess relationships between COPD and asthma with health impairment indicators. Five categories [COPD, current asthma, former asthma, overlap syndrome, and neither] were defined for 24,073 respondents. Associations of these categories with health impairments (physical or mental disability, use of special equipment, mental or physical distress) and with co-morbidities (diabetes, coronary heart disease, stroke, arthritis, and high blood pressure) were assessed.
Fifteen percent of NC adults reported a COPD and/or asthma history. The overall age-adjusted prevalence of any self-reported COPD and current asthma were 5.6% and 7.6%, respectively; 2.4% reported both. In multivariable analyses, adults with overlap syndrome, current asthma only, and COPD only were twice as likely as those with neither disease to report health impairments (p < 0.05). Compared to those with neither disease, adults with overlap syndrome and COPD were more likely to have co-morbidities (p < 0.05). The prevalence of the five co-morbid conditions was highest in overlap syndrome; comparisons with the other groups were significant (p < 0.05) only for diabetes, stroke, and arthritis.
The BRFSS demonstrates different levels of health impairment among persons with COPD, asthma, overlap syndrome, and those with neither disease. Persons reporting overlap syndrome had the most impairment and highest prevalence of co-morbidities.
摘要背景：慢性阻塞性肺疾病（COPD）患者和/或哮喘患者有很高的发病风险。目前缺乏针对特定州的监测数据来评估COPD或伴有哮喘的COPD（重叠综合征）对健康相关损害的影响。
使用北卡罗来纳州（NC）行为危险因素监测系统（BRFSS）评估COPD和哮喘与健康损害指标之间的关系。为24,073名受访者定义了五类[COPD、当前哮喘、既往哮喘、重叠综合征和两者皆无]。评估了这些类别与健康损害（身体或精神残疾、使用特殊设备、精神或身体困扰）以及合并症（糖尿病、冠心病、中风、关节炎和高血压）之间的关联。
15%的北卡罗来纳州成年人报告有COPD和/或哮喘病史。任何自我报告的COPD和当前哮喘的总体年龄调整患病率分别为5.6%和7.6%；2.4%的人同时报告了这两种疾病。在多变量分析中，患有重叠综合征、仅患有当前哮喘和仅患有COPD的成年人报告健康损害的可能性是未患这两种疾病的成年人的两倍（p < 0.05）。与未患这两种疾病的成年人相比，患有重叠综合征和COPD的成年人更有可能患有合并症（p < 0.05）。五种合并症的患病率在重叠综合征中最高；与其他组相比，仅糖尿病、中风和关节炎有显著差异（p < 0.05）。
BRFSS显示COPD、哮喘、重叠综合征患者以及未患这两种疾病的人群之间存在不同程度的健康损害。报告重叠综合征的人健康损害最严重，合并症患病率最高。
