Bajpai Jyoti, Kant Surya, Bajaj Darshan K, Pradhan Akshyaya, Srivastava Kanchan, Pandey Akhilesh K
Department of Respiratory Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India.
Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India.
J Family Med Prim Care. 2019 Jul;8(7):2364-2368. doi: 10.4103/jfmpc.jfmpc_347_19.
Cigarette smoking is the most predominant risk factor for development of chronic obstructive pulmonary disease (COPD). However, a considerable amount of patients do develop COPD without exposure to cigarette smoking. We aimed to analyze the incidence, demographic and clinical profile of nonsmoker COPD subjects at a tertiary care center.
In this prospective observational study, 410 patients were screened for dyspnea. On the basis of spirometry findings, 360 patients were diagnosed as COPD and enrolled into the study. Patients were categorized into 2 groups on the basis of smoking habits (smoker and nonsmoker COPD). Clinical and demographic attributes were compared in between these two groups. This study was conducted over a period of one year, from August 2014 to July 2015. All statistical analyses were performed using Statistical Package for the Social Sciences version 19.0 (SPSS Inc, Chicago, IL, USA). Values were considered to be statistically significant at < 0.05.
Out of 360 COPD cases, about 2/3 (60%) were smokers and the rest nonsmokers. Majority of the patients were in the age group of 51-70 years. The mean age of smokers with COPD was significantly higher than nonsmokers with COPD (59.29 ± 10.28 years vs. 53.90 ± 8.77 years; = 0.0001). Overall, males were predominant (57.2%) but there were higher number of female patients in nonsmoker group (25% vs. 70%; = 0.001). At presentation, majority of nonsmoker with COPD were in GOLD severity grade II while in the smoking cohort majority were in GOLD severity Grade III. Among the 144 nonsmoker COPD patients, the most important and statistically significant risk factor was exposure to biomass smoke (68.06%). Other risk factors were long-standing asthma (37.50%), lower respiratory tract infection in childhood (32.60%), exposure to outdoor air pollution (17.92%).
Nonsmoker COPD is emerging as a distinctive phenotype. They have less impairment in airflow limitation, and a lower prevalence of emphysema, chronic cough, and sputum compared with their smoking counterparts.
吸烟是慢性阻塞性肺疾病（COPD）发病的最主要危险因素。然而，相当一部分COPD患者并未接触过吸烟。我们旨在分析一家三级医疗中心非吸烟COPD患者的发病率、人口统计学和临床特征。
在这项前瞻性观察研究中，对410例有呼吸困难的患者进行了筛查。根据肺功能检查结果，360例患者被诊断为COPD并纳入研究。根据吸烟习惯将患者分为两组（吸烟和非吸烟COPD患者）。比较这两组患者的临床和人口统计学特征。本研究于2014年8月至2015年7月进行了一年。所有统计分析均使用社会科学统计软件包第19.0版（SPSS Inc，美国伊利诺伊州芝加哥）。P值<0.05被认为具有统计学意义。
在360例COPD病例中，约2/3（60%）为吸烟者，其余为非吸烟者。大多数患者年龄在51 - 70岁之间。吸烟的COPD患者的平均年龄显著高于非吸烟的COPD患者（59.29±10.28岁对53.90±8.77岁；P = 0.0001）。总体而言，男性占主导（57.2%），但非吸烟组女性患者数量较多（25%对70%；P = 0.001）。就诊时，大多数非吸烟的COPD患者处于GOLD严重程度分级II级，而吸烟组大多数处于GOLD严重程度分级III级。在144例非吸烟COPD患者中，最重要且具有统计学意义的危险因素是接触生物质烟雾（68.06%）。其他危险因素包括长期哮喘（37.50%）、儿童期下呼吸道感染（32.60%）、接触室外空气污染（17.92%）。
非吸烟COPD正在成为一种独特的表型。与吸烟的COPD患者相比，他们在气流受限方面的损害较小，肺气肿、慢性咳嗽和咳痰的患病率较低。
