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纳入疾病管理与预防项目的α-1抗胰蛋白酶缺乏症患者的获益情况。

Benefits Among Patients with Alpha-1 Antitrypsin Deficiency Enrolled in a Disease Management and Prevention Program.

作者信息

Perkins Jordan T, Choate Radmila, Mannino David M, Browning Stephen R, Sandhaus Robert A

机构信息

Department of Preventive Medicine and Environmental Health, University of Kentucky College of Public Health, Lexington.

Department of Epidemiology, University of Kentucky College of Public Health, Lexington.

出版信息

Chronic Obstr Pulm Dis. 2016 Dec 24;4(1):56-64. doi: 10.15326/jcopdf.4.1.2016.0161.

Abstract

Alpha-1 antitrypsin deficiency (AATD) is characterized by decreased circulating levels or activity of the serum protein, alpha-1 antitrypsin, which increases risk for chronic lung or liver injury and may lead to diseases such as chronic obstructive pulmonary disease (COPD). Currently there is no cure for AATD, and it is largely controlled through disease management and augmentation therapy. This study was designed to describe characteristics of patients enrolled in a disease management and prevention program. Data from questionnaires administered by AlphaNet were obtained on 4747 AATD patients and included demographic information, medical history, lifestyle choices, and adherence to the Alpha-1 Disease Management and Prevention Program (ADMAPP). A total of 1221 participants (25.72%) had missing adherence information and were excluded, leaving a final study population of 3526. Questionnaire answer dates ranged from May 29, 2008 to February 14, 2015. Logistic regression was used to adjust for demographic factors and comorbidities, comparing the populations stratified by adherence to ADMAPP. After adjustment for age, sex, race, Charlson Comorbidity Index, and income level, individuals who self-reported any adherence to ADMAPP were more likely to feel informed about their condition (odds ratio[OR] 4.95, 95% confidence interval[CI][3.24, 7.57]), and be taking preventive measures, such as smoking cessation (OR 0.47, 95% CI [0.31, 0.70]), appropriate immunizations, and self-reported exercise (OR 2.07, 95% CI [1.74, 2.47]). This study suggests that ADMAPP may be a useful tool for informing and improving preventive measures taken by individuals with AATD. Future studies are needed to clarify the observed associations and study additional outcomes.

摘要

α-1抗胰蛋白酶缺乏症(AATD)的特征是血清蛋白α-1抗胰蛋白酶的循环水平或活性降低,这会增加慢性肺或肝损伤的风险,并可能导致诸如慢性阻塞性肺疾病(COPD)等疾病。目前,AATD无法治愈,主要通过疾病管理和增强疗法进行控制。本研究旨在描述参与疾病管理和预防计划的患者的特征。从AlphaNet发放的问卷中获取了4747名AATD患者的数据,包括人口统计学信息、病史、生活方式选择以及对α-1疾病管理和预防计划(ADMAPP)的依从性。共有1221名参与者(25.72%)缺失依从性信息,被排除在外,最终研究人群为3526人。问卷回答日期从2008年5月29日至2015年2月14日。采用逻辑回归对人口统计学因素和合并症进行调整,比较按对ADMAPP的依从性分层的人群。在对年龄、性别、种族、查尔森合并症指数和收入水平进行调整后,自我报告对ADMAPP有任何依从性的个体更有可能了解自己的病情(优势比[OR]为4.95,95%置信区间[CI][3.24, 7.57]),并采取预防措施,如戒烟(OR为0.47,95% CI [0.31, 0.70])、适当接种疫苗以及自我报告的锻炼(OR为2.07,95% CI [1.74, 2.47])。本研究表明,ADMAPP可能是一个有用的工具,可用于告知AATD患者并改善他们采取的预防措施。未来需要开展研究以阐明观察到的关联并研究其他结果。

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