Uslu Berat, Gülsen Askin, Arpinar Yigitbas Burcu
Department of Chest Diseases, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey.
Interdisciplinary Allergy Outpatient Clinic, Department of Pneumology, University of Luebeck, Germany.
Tanaffos. 2022 Mar;21(3):307-316.
Acute exacerbation events, which can develop during the natural course of chronic obstructive pulmonary disease (COPD) can lead to worsening quality of life, increased hospital costs, and higher rates of morbidity and mortality. In recent years, individuals at heightened risk of COPD exacerbations have been said to display a so-called "frequent exacerbator (FE)" phenotype, defined as having two or more exacerbation events (or ≥ 1 exacerbation with a hospitalization) within 1 year.
We conducted a retrospective study involving 299 patients with COPD. Patients were divided into 2 groups as non-exacerbator phenotype (group-1, n=195) and FE phenotype (group-2, n=104).
FE phenotype was identified in 35.1% of patients. There were no significant differences between these two phenotypes in terms of gender, smoking status, or leukocyte count. However, FEs were found to be older (p=0.04), with more frequent detection of emphysema (p=0.02) and lower eosinophil levels (p=0.02). FEs also demonstrated worse pulmonary function parameters.
COPD patients with the FE phenotype likely require a different treatment algorithm due to differing clinical features such as poorer respiratory function, lower eosinophil levels, and more frequent emphysema.
急性加重事件可在慢性阻塞性肺疾病（COPD）的自然病程中发生，会导致生活质量下降、住院费用增加以及更高的发病率和死亡率。近年来，据说慢性阻塞性肺疾病急性加重风险较高的个体表现出一种所谓的“频繁急性加重者（FE）”表型，定义为在1年内发生两次或更多次急性加重事件（或≥1次因急性加重而住院）。
我们进行了一项回顾性研究，纳入了299例慢性阻塞性肺疾病患者。患者被分为两组，即非急性加重者表型组（第1组，n = 195）和频繁急性加重者表型组（第2组，n = 104）。
35.1%的患者被确定为频繁急性加重者表型。这两种表型在性别、吸烟状况或白细胞计数方面无显著差异。然而，频繁急性加重者年龄较大（p = 0.04），肺气肿检出率更高（p = 0.02），嗜酸性粒细胞水平更低（p = 0.02）。频繁急性加重者的肺功能参数也更差。
由于呼吸功能较差、嗜酸性粒细胞水平较低和肺气肿更常见等不同的临床特征，频繁急性加重者表型的慢性阻塞性肺疾病患者可能需要不同的治疗方案。
