Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, People's Republic of China.
Department of Respiratory and Critical Care Medicine, Tibet Autonomous Region People's Hospital, Lhasa, 850000, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2021 Aug 26;16:2445-2454. doi: 10.2147/COPD.S325097. eCollection 2021.
COPD at high altitude may have different risk factors and unique clinical and radiological phenotypes. We aimed to investigate the demographic data, clinical and radiological features of COPD patients permanently residing at the Tibet Plateau (≥3000 meters above sea level).
We conducted an observational cross-sectional study which consecutively enrolled COPD patients visiting the outpatient of Respiratory Medicine at Tibet Autonomous Region People's Hospital from January 2018 to March 2021. All patients were Tibetan permanent residents aging ≥40 years and met the diagnosis of COPD according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. Data including demographic characteristics, altitude of residence, risk factors, respiratory symptoms, comorbidities and medications, as well as computed tomography (CT) measurements were collected.
Eighty-four patients with definite COPD were enrolled for analysis. Their mean age was 64.7 (±9.1) years. All patients lived at ≥3000 m above sea level and 34.5% of them lived at ≥4000 m. About 8.3% of the patients were current smokers and 44.0% were ex-smokers. Up to 88.1% of the patients reported long-term exposure to indoor biomass fuels. Most of the patients were classified as having mild-to-moderate (GOLD I: 27.4%; GOLD II: 51.2%) COPD, while 89.3% had a CAT score ≥10. Only 36.9% of the patients received regular long-term medications for COPD in the past year, in whom ICS/LABA and oral theophylline were the most common used pharmacological therapy. On CT scanning, the majority of our patients (70.7%) showed no or minimal emphysema, while signs of previous tuberculosis were found in 45.1% of the patients.
COPD patients living at the Tibet Plateau had a heavy respiratory symptom burden, but most of them did not receive adequate pharmacological treatment. Indoor biomass fuel exposure and previous tuberculosis were prevalent, while the emphysema phenotype was less common in this population.
高海拔地区的 COPD 可能有不同的危险因素和独特的临床及影像学表型。我们旨在研究长期居住在青藏高原（海拔≥3000 米）的 COPD 患者的人口统计学数据、临床和影像学特征。
我们进行了一项观察性的横断面研究，连续纳入了 2018 年 1 月至 2021 年 3 月期间在西藏自治区人民医院呼吸内科门诊就诊的 COPD 患者。所有患者均为藏族常住居民，年龄≥40 岁，并根据全球慢性阻塞性肺疾病倡议（GOLD）指南诊断为 COPD。收集了包括人口统计学特征、居住海拔、危险因素、呼吸系统症状、合并症和药物治疗以及计算机断层扫描（CT）测量等数据。
共纳入 84 例确诊 COPD 患者进行分析。他们的平均年龄为 64.7（±9.1）岁。所有患者均居住在海拔≥3000 米以上的地区，其中 34.5%的患者居住在海拔≥4000 米的地区。约 8.3%的患者为当前吸烟者，44.0%为戒烟者。高达 88.1%的患者报告长期暴露于室内生物质燃料。大多数患者被归类为轻至中度 COPD（GOLD I：27.4%；GOLD II：51.2%），而 89.3%的患者 CAT 评分≥10。过去一年中，只有 36.9%的患者接受了规律的 COPD 长期药物治疗，其中最常用的药物治疗是 ICS/LABA 和口服茶碱。在 CT 扫描中，我们的大多数患者（70.7%）无或仅有轻微肺气肿表现，而 45.1%的患者有既往肺结核的征象。
居住在青藏高原的 COPD 患者有较重的呼吸系统症状负担，但大多数患者未接受充分的药物治疗。室内生物质燃料暴露和既往肺结核较为普遍，而肺气肿表型在该人群中较少见。
