Haraguchi Mizuha, Nakamura Hidetoshi, Sasaki Mamoru, Miyazaki Masaki, Chubachi Shotaro, Takahashi Saeko, Asano Koichiro, Jones Paul W, Betsuyaku Tomoko
Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Department of Respiratory Medicine, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.
BMC Res Notes. 2016 Jan 4;9:7. doi: 10.1186/s13104-015-1810-8.
Although the age range of chronic obstructive pulmonary disease (COPD) patients is broad, few studies have focused on the effects of age on disease characteristics.
Keio University and affiliated hospitals established an observational COPD cohort. Patients were assessed using high resolution computed tomography (CT) to quantify emphysema, health status using the COPD assessment test (CAT) and the St. George's Respiratory Questionnaire (SGRQ), spirometry, echocardiogram, dual X-ray absorption of bone, biomarkers and comorbid diagnoses. We examined the characteristics of COPD patients aged 75 and over compared with patients below 75.
A total of 443 patients comprising 252 patients aged <75 years and 191 patients aged ≥75 years, were enrolled. Emphysematous changes on CT and prevalence of possible pulmonary hypertension were greater in late-elderly patients. The slope of the relationship between CT emphysema densitometry score and forced expiratory volume in 1 s was significantly less steep in the late-elderly than the younger patients (p = 0.002). CAT and total SGRQ scores and the frequency of long-term oxygen therapy were significantly higher in the late-elderly with moderate airflow obstruction compared to those of the younger in the same grade, although the opposite was seen in late-elderly patients with very severe airflow obstruction. Hypertension, aortic aneurysm, prostatic hypertrophy, anemia, and cataract are more prevalent in late-elderly patients.
Elderly COPD patients show a varied age-related pattern of disease that warrants specific attention in clinical practice above and beyond assessment of airflow limitation. Trial registration Clinical trial registered with the University Hospital Medical Information Network (UMIN000003470, April 10, 2010).
尽管慢性阻塞性肺疾病（COPD）患者的年龄范围很广，但很少有研究关注年龄对疾病特征的影响。
庆应义塾大学及其附属医院建立了一个COPD观察队列。使用高分辨率计算机断层扫描（CT）评估患者的肺气肿情况，使用COPD评估测试（CAT）和圣乔治呼吸问卷（SGRQ）评估健康状况，进行肺功能测定、超声心动图检查、双能X线骨吸收检查、生物标志物检测和合并症诊断。我们比较了75岁及以上COPD患者与75岁以下患者的特征。
共纳入443例患者，其中252例年龄<75岁，191例年龄≥75岁。老年患者CT上的肺气肿改变和可能的肺动脉高压患病率更高。与年轻患者相比，老年患者CT肺气肿密度测定评分与第1秒用力呼气量之间关系的斜率明显更平缓（p = 0.002）。在中度气流受限的老年患者中，CAT和SGRQ总分以及长期氧疗的频率明显高于同级别年轻患者，尽管在极重度气流受限的老年患者中情况相反。高血压、主动脉瘤、前列腺肥大、贫血和白内障在老年患者中更为普遍。
老年COPD患者表现出与年龄相关的多种疾病模式，在临床实践中，除了评估气流受限外，还需要特别关注。试验注册 在大学医院医学信息网络注册的临床试验（UMIN000003470，2010年4月10日）。
