Katajisto Milla, Koskela Jukka, Lindqvist Ari, Kilpeläinen Maritta, Laitinen Tarja
Clinical Research Unit of Pulmonary Diseases and Division of Pulmonology HUCH Heart and Lung Center, University of Helsinki and Helsinki University Hospital, Finland.
Clinical Research Unit of Pulmonary Diseases and Division of Pulmonology HUCH Heart and Lung Center, University of Helsinki and Helsinki University Hospital, Finland.
Respir Med. 2015 Oct;109(10):1320-5. doi: 10.1016/j.rmed.2015.08.001. Epub 2015 Aug 6.
Physically inactive patients with chronic obstructive pulmonary disease (COPD) exhibit higher rates of exacerbations and symptoms of dyspnoea than active patients. Whether the use of COPD medication explains these differences is not known.
This study evaluated differences in the use of COPD medication and the number of exacerbations due to physical activity.
A COPD cohort (N = 719) was followed through medical records to identify hospital admissions, and exercise activity was evaluated using mailed questionnaires. The national drug reimbursement registry identified drug purchases for one year.
The use of maintenance therapies, such as long-acting muscarinic antagonists (LAMAs), long-acting beta agonists (LABAs), inhaled corticosteroids (ICS), and theophylline, did not differ significantly between physically active (N = 346) and inactive (N = 355) COPD patients. The cumulative dose of salbutamol (85 vs. 218 mg, adjusted P = 0.01) and oral corticosteroids (OCS) (621 vs. 1068 mg, adjusted P = 0.02) were significantly higher in inactive patients, regardless of disease severity. LABAs, LAMAs, and ICS were used in reduced doses in both patient groups compared to daily defined doses (DDD). Physical activity was independently associated with the number of hospital admissions and the use of OCS and short-acting bronchodilators.
Physical inactivity in COPD was not associated with poorer use of maintenance therapies. In contrast, inactivity was independently associated with the number of exacerbations measured by hospital admissions and the use of OCS and short-acting symptom-relieving medications.
与活动的慢性阻塞性肺疾病（COPD）患者相比，身体不活动的患者急性加重率和呼吸困难症状更高。COPD药物的使用是否能解释这些差异尚不清楚。
本研究评估了COPD药物使用及因身体活动导致的急性加重次数的差异。
通过病历随访一个COPD队列（N = 719）以确定住院情况，并使用邮寄问卷评估运动活动。国家药物报销登记处确定了一年的药物购买情况。
在身体活动的COPD患者（N = 346）和不活动的患者（N = 355）之间，长效毒蕈碱拮抗剂（LAMA）、长效β受体激动剂（LABA）、吸入性糖皮质激素（ICS）和茶碱等维持治疗药物的使用无显著差异。无论疾病严重程度如何，不活动患者的沙丁胺醇累积剂量（85 vs. 218 mg，校正P = 0.01）和口服糖皮质激素（OCS）（621 vs. 1068 mg，校正P = 0.02）均显著更高。与每日限定剂量（DDD）相比，两组患者使用的LABA、LAMA和ICS剂量均降低。身体活动与住院次数、OCS和短效支气管扩张剂的使用独立相关。
COPD患者身体不活动与维持治疗药物使用较差无关。相反，不活动与通过住院次数衡量的急性加重次数以及OCS和短效缓解症状药物的使用独立相关。
