Ding Fang, Liu Wenjing, Hu Xiaoying, Gao Chunyan
Department of Geriatrics, Harrison International Peace Hospital, Intersection of Renmin Road, Hongqi Street, Taocheng District, Hengshui City, Hebei Province, 053000, China.
Department of Respiratory and Critical Care Medicine, Harrison International Peace Hospital, Hengshui, China.
BMC Pulm Med. 2025 Jan 4;25(1):5. doi: 10.1186/s12890-024-03346-6.
To explore the factors related to the progression of chronic obstructive pulmonary disease (COPD).
80 COPD patients treated between January 2020 and December 2022. The patients' pulmonary functions at their first hospital admission were categorized into four groups: Grade I, Grade II, Grade III and Grade IV. Each group was further divided into a progression group and a non-progression group based on the disease progression over one year or several years of follow-up. Patients with other respiratory diseases, malignant tumors, severe heart, kidney, liver dysfunctions, or immune deficiencies affecting the prognosis were excluded. General information, clinical data, treatment data, and statistical analysis of the patients.
In comparison with the non-progression group, the progression group had significantly higher age, smoking behavior, COPD history, hemoptysis history, CRP levels, IL-6 levels, and Pneumonia Severity Index (PSI) scores, exhibiting significantly lower FEV1, FEV1% predicted, PaO2, and PaCO2. More frequent use of antibiotics, corticosteroids, oxygen therapy, and mechanical ventilation were observed in the progression group than that in the non-progression group (P < 0.05). As a consequence, the progression group had a worse prognosis as indicated by higher hospitalization costs, longer hospital stay, and higher rate of acute exacerbations than the non-progression group (P < 0.05). Multifactorial logistic regression analysis showed that age ≥ 65 years, PSI score ≥ 130 points, and multidrug-resistant bacteria infection were independent risk factors for the progression of COPD (P < 0.05).
Older COPD patients, higher PSI score, and multidrug-resistant bacteria infection have a worse prognosis and need more intensive treatment and follow-up.
探讨与慢性阻塞性肺疾病（COPD）进展相关的因素。
选取2020年1月至2022年12月期间接受治疗的80例COPD患者。将患者首次入院时的肺功能分为四组：Ⅰ级、Ⅱ级、Ⅲ级和Ⅳ级。根据一年或数年随访期间的疾病进展情况，每组再进一步分为进展组和非进展组。排除患有其他呼吸系统疾病、恶性肿瘤、严重心、肾、肝功能障碍或影响预后的免疫缺陷患者。对患者的一般信息、临床资料、治疗数据进行统计分析。
与非进展组相比，进展组患者的年龄、吸烟行为、COPD病史、咯血病史、CRP水平、IL-6水平及肺炎严重程度指数（PSI）评分显著更高，而FEV1、预测FEV1%、PaO2及PaCO2显著更低。进展组抗生素、皮质类固醇、氧疗及机械通气的使用频率高于非进展组（P < 0.05）。因此，进展组的住院费用更高、住院时间更长、急性加重率更高，预后比非进展组更差（P < 0.05）。多因素logistic回归分析显示，年龄≥65岁、PSI评分≥130分及多重耐药菌感染是COPD进展的独立危险因素（P < 0.05）。
老年COPD患者、较高的PSI评分及多重耐药菌感染预后较差，需要更积极的治疗及随访。
