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德国“真实生活”中的慢性阻塞性肺疾病患者:DACCORD研究。

The 'real-life' COPD patient in Germany: The DACCORD study.

作者信息

Worth Heinrich, Buhl Roland, Criée Carl-Peter, Kardos Peter, Mailänder Claudia, Vogelmeier Claus

机构信息

Facharztforum Fürth, 90762, Fürth, Germany.

Pulmonary Department, Mainz University Hospital, 55131, Mainz, Germany.

出版信息

Respir Med. 2016 Feb;111:64-71. doi: 10.1016/j.rmed.2015.12.010. Epub 2015 Dec 30.

Abstract

INTRODUCTION

DACCORD is an ongoing, longitudinal, non-interventional study within the German COPD National Prospective Registry. This manuscript describes the baseline characteristics of the first 5924 participants, recruited between November 2012 and November 2013.

METHODS

The main inclusion criteria are a physician diagnosis of COPD, age ≥40 years, and initiating or changing COPD maintenance medication. Data collected included: Demographic and disease characteristics; prescribed medication; symptoms; COPD Assessment Test (CAT); modified Medical Research Council dyspnoea score (mMRC); exacerbations; comorbidities; and forced expiratory volume in 1 s (FEV1).

RESULTS

Approximately 60% of the population are male, with mean age of 65.7 years and FEV1 61.6% predicted. On entry to the study the majority of patients reported symptoms, most commonly exertional dyspnoea (85.9%) and cough (65.7%). According to GOLD 2010, 48.6% of patients were classified as GOLD II. GOLD 2011 classification was influenced by the symptoms criterion: 43.7 and 45.3% of patients were classified as GOLD B or D using CAT, compared with 26.4 and 34.0%, respectively, using mMRC. The majority of patients were receiving a LAMA-containing regimen, with 39.4% overall receiving ICS. A total of 78.3% of patients reported at least one comorbidity, most commonly cardiovascular.

CONCLUSION

In conclusion, DACCORD is a large, prospective, non-interventional study that provides an informative and intriguing picture of the typical COPD patient in Germany.

摘要

引言

DACCORD是德国慢性阻塞性肺疾病(COPD)国家前瞻性登记处正在进行的一项纵向非干预性研究。本手稿描述了2012年11月至2013年11月招募的首批5924名参与者的基线特征。

方法

主要纳入标准为医生诊断为COPD、年龄≥40岁以及开始或改变COPD维持治疗药物。收集的数据包括:人口统计学和疾病特征、处方药物、症状、COPD评估测试(CAT)、改良医学研究委员会呼吸困难评分(mMRC)、急性加重、合并症以及1秒用力呼气容积(FEV1)。

结果

大约60%的研究对象为男性,平均年龄65.7岁,FEV1为预测值的61.6%。在进入研究时,大多数患者报告有症状,最常见的是劳力性呼吸困难(85.9%)和咳嗽(65.7%)。根据《慢性阻塞性肺疾病全球倡议》(GOLD)2010版,48.6%的患者被归类为GOLD II级。GOLD 2011版分类受症状标准影响:使用CAT时,43.7%和45.3%的患者被归类为GOLD B或D级,而使用mMRC时,这一比例分别为26.4%和34.0%。大多数患者接受含长效抗胆碱能药物(LAMA)的治疗方案,总体上39.4%的患者接受吸入性糖皮质激素(ICS)治疗。共有78.3%的患者报告至少有一种合并症,最常见的是心血管疾病。

结论

总之,DACCORD是一项大型前瞻性非干预性研究,它为德国典型的COPD患者提供了丰富且引人关注的情况。

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