Montserrat-Capdevila Josep, Godoy Pere, Marsal Josep Ramon, Ortega Marta, Barbé Ferran, Castañ Maria Teresa, Seminario María Asunción, Pujol Jesús, Alsedà Miquel
Consultorio Local de Bellvís, ABS Pla d'Urgell, Atención Primaria, Institut Català de la Salut, Bellvís, Lleida, España; Institut de Recerca Biomèdica (IRB) de Lleida, Lleida, España; Agència de Salut Pública de Catalunya, Departament de Salut, Lleida, España; Facultat de Medicina, Universitat de Lleida, Lleida, España.
Institut de Recerca Biomèdica (IRB) de Lleida, Lleida, España; Agència de Salut Pública de Catalunya, Departament de Salut, Lleida, España; Facultat de Medicina, Universitat de Lleida, Lleida, España; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, España.
Aten Primaria. 2019 Dec;51(10):602-609. doi: 10.1016/j.aprim.2017.10.012. Epub 2018 Nov 16.
The objective of the study was to know the profile of patients diagnosed with chronic obstructive pulmonary disease (COPD) and who have never been smokers.
A transversal study.
Primary Care Centre of Pla d'Urgell (Primary care setting in Lleida, Spain).
512 patients older than 40 years with COPD from Primary Care Centre of Pla d'Urgell with a compatible spirometry [forced expiratory volume in one second (FEV)/forced vital capacity (FVC) ratio <0.7) to the beginning of the study.
The dependent variable was de COPD in non-smokers and the independents were variables collected from the information on the respiratory clinical history, the risk factors of the patients and on quality of life. We designed a predictor model of COPD in non-smokers compared to smokers.
33.2% of COPD patients had never been smokers, 59.4% of whom were women. The average FEV for non-smokers was 70.5 (SD=17.1), higher than 62.6 (SD=18.5) for smokers/former smokers (p<0.001). The coverage of pneumococcal vaccination 23V was better in non-smokers (75.3%), p<0.001. COPD in non-smokers (compared to smokers/former smokers) were: mostly women (OR=16.46), older (OR=1.1), with better FEV (OR=1.1), better perception of quality, EuroQoL-5D (OR=0.8), with lower prevalence of diabetes (OR=0.5), lower level of studies (OR=0.2), and with fewer previous hospitalizations (OR=0.3).
The study evidences a high proportion of non-smokers in COPD patients. Our study aims that older women with less severity would be associated with an increased risk of COPD in non-smokers. It seems to indicate that COPD in non-smokers would appear at later ages and would be milder than smoking-related COPD.
本研究的目的是了解被诊断为慢性阻塞性肺疾病(COPD)且从未吸烟的患者的概况。
一项横断面研究。
普拉德乌尔盖尔初级保健中心(西班牙莱里达的初级保健机构)。
来自普拉德乌尔盖尔初级保健中心的512名40岁以上的COPD患者,在研究开始时肺功能测定[一秒用力呼气容积(FEV)/用力肺活量(FVC)比值<0.7]符合标准。
因变量是非吸烟者中的慢性阻塞性肺疾病,自变量是从呼吸临床病史、患者危险因素和生活质量信息中收集的变量。我们设计了一个与吸烟者相比的非吸烟者慢性阻塞性肺疾病预测模型。
33.2%的慢性阻塞性肺疾病患者从未吸烟,其中59.4%为女性。非吸烟者的平均FEV为70.5(标准差=17.1),高于吸烟者/既往吸烟者的62.6(标准差=18.5)(p<0.001)。非吸烟者中23价肺炎球菌疫苗接种率更高(75.3%),p<0.001。非吸烟者(与吸烟者/既往吸烟者相比)患慢性阻塞性肺疾病的情况为:大多为女性(比值比=16.46)、年龄较大(比值比=1.1)、FEV较好(比值比=1.1)、生活质量感知较好、欧洲五维健康量表(EuroQoL-5D)(比值比=0.8)、糖尿病患病率较低(比值比=0.5)、受教育程度较低(比值比=0.2)且既往住院次数较少(比值比=0.3)。
该研究证明慢性阻塞性肺疾病患者中不吸烟者的比例很高。我们的研究旨在表明病情较轻的老年女性与非吸烟者患慢性阻塞性肺疾病的风险增加有关。这似乎表明非吸烟者的慢性阻塞性肺疾病发病年龄较晚,且比与吸烟相关的慢性阻塞性肺疾病症状较轻。