Kilic Hatice, Kokturk Nurdan, Sari Gulcin, Cakır Mustafa
Department of Pulmonary Medicine, Ankara Atatürk Training and Research Hospital, Gazi University, Ankara, Turkey.
Department of Pulmonary Medicine, School of Medicine, Gazi University School of Medicine, Gazi University, Ankara, Turkey.
Int J Chron Obstruct Pulmon Dis. 2015 Apr 24;10:823-30. doi: 10.2147/COPD.S78952. eCollection 2015.
Little is known about whether there is any sex effect on chronic obstructive lung disease (COPD) exacerbations. This study is intended to describe the possible sex-associated differences in exacerbation profile in COPD patients.
A total of 384 COPD patients who were hospitalized due to exacerbation were evaluated retrospectively for their demographics and previous and current exacerbation characteristics.
The study was conducted on 109 (28%) female patients and 275 (72%) male patients. The mean age was 68.30±10.46 years. Although females had better forced expiratory volume in 1 second and near-normal forced vital capacity, they had much impaired arterial blood gas levels (partial oxygen pressure [PO2] was 36.28 mmHg vs 57.93 mmHg; partial carbon dioxide pressure [PCO2] was 45.97 mmHg vs 42.49 mmHg; P=0.001), indicating severe exacerbation with respiratory failure. More females had two exacerbations and two hospitalizations, while more men had one exacerbation and one hospitalization. Low adherence to treatment and pulmonary embolism were more frequent in females. Females had longer time from the onset of symptoms till the admission and longer hospitalization duration than males. Comorbidities were less in number and different in women (P<0.05). Women were undertreated and using more oral corticosteroids.
Current data showed that female COPD patients might be more prone to have severe exacerbations, a higher number of hospitalizations, and prolonged length of stay for hospitalization. They have a different comorbidity profile and might be undertreated for COPD.
关于慢性阻塞性肺疾病(COPD)急性加重是否存在性别差异,目前知之甚少。本研究旨在描述COPD患者急性加重特征中可能存在的性别相关差异。
对384例因急性加重住院的COPD患者的人口统计学资料以及既往和当前急性加重特征进行回顾性评估。
本研究纳入109例(28%)女性患者和275例(72%)男性患者。平均年龄为68.30±10.46岁。尽管女性的1秒用力呼气量较好且用力肺活量接近正常,但她们的动脉血气水平受损更严重(氧分压[PO2]为36.28 mmHg对57.93 mmHg;二氧化碳分压[PCO2]为45.97 mmHg对42.49 mmHg;P = 0.001),表明伴有呼吸衰竭的严重急性加重。更多女性有两次急性加重和两次住院,而更多男性有一次急性加重和一次住院。女性治疗依从性差和肺栓塞更为常见。女性从症状出现到入院的时间和住院时间均长于男性。女性的合并症数量较少且种类不同(P<0.05)。女性治疗不足且使用更多口服糖皮质激素。
目前的数据表明,女性COPD患者可能更容易发生严重急性加重、住院次数更多且住院时间延长。她们有不同的合并症谱,且COPD治疗可能不足。