Miravitlles M, Barrecheguren M, Román-Rodríguez M
Pneumology Department, Hospital General Universitari Vall d'Hebron, Ciber de Enfermedades Respiratorias (CIBERES), Barcelona, Spain.
Primary Health Care Center Son Pisà, Primary Care Respiratory Research Unit, Instituto de Investigación Sanitaria de Palma, Palma de Mallorca, Spain.
Int J Tuberc Lung Dis. 2015 Aug;19(8):992-8. doi: 10.5588/ijtld.15.0021.
Clinical phenotypes of chronic obstructive pulmonary disease (COPD) identify patients with common characteristics.
To investigate the distribution of four different COPD phenotypes: non-exacerbators, patients with asthma-COPD overlap syndrome (ACOS), exacerbators with chronic bronchitis and those without, we analysed the impact of COPD on quality of life (HRQoL), and on anxiety and depression in these phenotypes.
Observational, multicentre study conducted among 3125 COPD patients recruited from out-patient clinics in Barcelona, Spain. Phenotyping was performed based on the clinical information available. The COPD Assessment Test and EuroQoL-5 Dimensions questionnaire were used to evaluate HRQoL; patient mood was evaluated using the Hospital Anxiety and Depression Scale (HADS).
The distribution of phenotypes was as follows: 60.6% non-exacerbators, 15.9% ACOS patients, 19.3% exacerbators with chronic bronchitis and 4.3% exacerbators without chronic bronchitis. Non-exacerbators had milder COPD, whereas exacerbators presented with the most severe disease, with little difference between those with and those without chronic bronchitis. ACOS patients were more frequently female with better lung function, but more impaired HRQoL and greater anxiety and depression, than non-exacerbators.
Almost two thirds of COPD patients are non-exacerbators, and 15.9% have ACOS. Different phenotypes showed different demographic and clinical characteristics as well as impact on HRQoL and mood.
慢性阻塞性肺疾病（COPD）的临床表型可识别具有共同特征的患者。
为了研究四种不同COPD表型的分布情况：非急性加重期患者、哮喘-COPD重叠综合征（ACOS）患者、伴有慢性支气管炎的急性加重期患者和不伴有慢性支气管炎的急性加重期患者，我们分析了COPD对这些表型患者生活质量（HRQoL）以及焦虑和抑郁的影响。
在西班牙巴塞罗那门诊招募的3125例COPD患者中进行的观察性多中心研究。根据现有的临床信息进行表型分析。使用COPD评估测试和欧洲五维健康量表问卷来评估HRQoL；使用医院焦虑抑郁量表（HADS）评估患者情绪。
表型分布如下：60.6%为非急性加重期患者，15.9%为ACOS患者，19.3%为伴有慢性支气管炎的急性加重期患者，4.3%为不伴有慢性支气管炎的急性加重期患者。非急性加重期患者的COPD病情较轻，而急性加重期患者的病情最为严重，伴有和不伴有慢性支气管炎的患者之间差异不大。与非急性加重期患者相比，ACOS患者女性更为常见，肺功能较好，但HRQoL受损更严重，焦虑和抑郁程度更高。
几乎三分之二的COPD患者为非急性加重期患者，15.9%患有ACOS。不同表型显示出不同的人口统计学和临床特征，以及对HRQoL和情绪的影响。
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