Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.
Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea.
Chest. 2021 Jan;159(1):128-137. doi: 10.1016/j.chest.2020.08.017. Epub 2020 Aug 14.
The presence and progression of interstitial lung abnormalities (ILAs) is known to be associated with a decline of lung function and increased risk of mortality.
We aimed to elucidate the clinical course according to ILAs in patients with COPD.
A retrospective study was conducted between January 2013 and December 2018 of COPD patients who underwent chest CT imaging and longitudinal pulmonary function tests. We evaluated radiologic findings, history of acute exacerbations of COPD, and lung function changes during the longitudinal follow-up.
Of 363 patients with COPD, 44 and 103 patients had equivocal and definite ILAs, respectively. Patients with ILAs were significantly older and had lower FEV and FVC than patients without ILAs. During the mean follow-up period of 5.2 years, ILAs were associated significantly with the annual incidence of moderate to severe acute exacerbation of COPD (β ± SD, 0.38 ± 0.12; P = .002) and with the risk of frequent exacerbation (adjusted OR, 2.03; P = .045). Patients with progressive ILAs showed a significantly higher rate of annual decline in FEV and FVC than those showing no change in, or improved, ILAs.
ILAs were associated significantly with moderate to severe acute exacerbation in patients with COPD, and the progression of ILAs was associated with an accelerated decline in lung function.
已知间质性肺异常（ILAs）的存在和进展与肺功能下降和死亡率增加有关。
我们旨在阐明 COPD 患者中根据 ILAs 存在情况的临床病程。
这是一项回顾性研究，于 2013 年 1 月至 2018 年 12 月期间对接受胸部 CT 成像和纵向肺功能测试的 COPD 患者进行。我们评估了影像学发现、COPD 急性加重病史以及纵向随访期间的肺功能变化。
在 363 例 COPD 患者中，44 例和 103 例患者分别存在疑似和明确的 ILAs。存在 ILAs 的患者明显比无 ILAs 的患者年龄更大，FEV 和 FVC 更低。在平均 5.2 年的随访期间，ILAs 与 COPD 中至重度急性加重的年度发生率显著相关（β ± SD，0.38 ± 0.12；P =.002），与频繁加重的风险相关（调整后的 OR，2.03；P =.045）。ILAs 进展的患者的 FEV 和 FVC 年下降率明显高于 ILAs 无变化或改善的患者。
ILAs 与 COPD 患者中中至重度急性加重显著相关，ILAs 的进展与肺功能的加速下降相关。
