非吸烟患者慢性阻塞性肺疾病（COPD）表型的性别差异。
Sex differences of COPD phenotypes in nonsmoking patients.
作者信息
Hong Yoonki, Ji Wonjun, An Soojeong, Han Seon-Sook, Lee Seung-Joon, Kim Woo Jin
机构信息
Department of Internal Medicine, Environmental Health Center, Kangwon National University Hospital, Chuncheon, South Korea.
Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
出版信息
Int J Chron Obstruct Pulmon Dis. 2016 Jul 22;11:1657-62. doi: 10.2147/COPD.S108343. eCollection 2016.
BACKGROUND
There is growing evidence about sex-related phenotypes of COPD. However, the sex differences in COPD mainly result from smokers. This study evaluated the sex differences in nonsmoking patients with COPD, focusing on structural changes in the lungs in airway diseases and emphysema.
METHODS
Ninety-seven nonsmoking patients, defined as having <1 pack-year of lifetime cigarette smoking, diagnosed with COPD were selected from a Korean COPD cohort. Emphysema extent and mean wall area percentage (WA%) on computed tomography were compared between the male and female groups.
RESULTS
The 97 patients with COPD included 62 females and 35 males. Emphysema index was significantly lower (3.5±4.2 vs 6.2±5.7, P<0.01) and mean WA% on computed tomography was significantly higher (71.8%±5% vs 69.4%±5%, P<0.01) in females than in males, after adjusting for age, body mass index, history of biomass exposure, and postbronchodilator forced expiratory volume in 1 second (% of predicted).
CONCLUSION
WA% was higher and emphysema extent was lower in nonsmoking females with COPD than in nonsmoking males with COPD. These findings suggest that males may be predisposed to an emphysema phenotype and females may be predisposed to an airway phenotype of COPD.
背景
慢性阻塞性肺疾病（COPD）与性别相关的表型证据越来越多。然而，COPD中的性别差异主要源于吸烟者。本研究评估了非吸烟COPD患者的性别差异，重点关注气道疾病和肺气肿中肺部的结构变化。
方法
从韩国COPD队列中选取97名被诊断为COPD的非吸烟患者，定义为终生吸烟量<1包年。比较男性和女性组在计算机断层扫描上的肺气肿程度和平均壁面积百分比（WA%）。
结果
97例COPD患者中，女性62例，男性35例。在调整年龄、体重指数、生物质暴露史和支气管扩张剂后1秒用力呼气量（预测值的百分比）后，女性的肺气肿指数显著低于男性（3.5±4.2对6.2±5.7，P<0.01），计算机断层扫描上的平均WA%显著高于男性（71.8%±5%对69.4%±5%，P<0.01）。
结论
非吸烟女性COPD患者的WA%高于非吸烟男性COPD患者，肺气肿程度低于后者。这些发现表明，男性可能易患肺气肿表型，而女性可能易患COPD的气道表型。
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