Herrera Lopez Astrid Berena, Torres-Duque Carlos A, Casas Herrera Alejandro, Arbeláez María Patricia, Riojas-Rodríguez Horacio, Texcalac-Sangrador José Luis, Rojas Néstor Y, Rodriguez-Villamizar Laura Andrea
Facultad de Medicina, Universidad de los Andes, Bogotá D.C, Colombia, Universidad de Antioquia, Medellín, Antioquia, Colombia.
CINEUMO, Fundación Neumológica Colombiana, Bogotá, Colombia.
Int J Chron Obstruct Pulmon Dis. 2025 Feb 22;20:425-435. doi: 10.2147/COPD.S498437. eCollection 2025.
Exacerbations of chronic obstructive pulmonary disease (COPD-E) have been associated with levels of air pollution. The occurrence of COPD-E is associated with increased mortality in this population.
To determine the association between long-term exposure to PM and NO, and the frequency of COPD-E in patients belonging to AIREPOC, an institutional integrated care program for COPD in Bogota, Colombia.
Retrospective cohort study included patients with COPD living in Bogotá, between 2018 and 2021, who received health care in the AIREPOC program. Each patient´s home address was geolocated. Information from local air quality network stations was used to estimate daily and annual mean PM and NO exposure level for each patient using the inverse distance squared weighted regression (IDWR) method. The effect of PM and NO concentrations categorized at 15 µg/m and 25 µg/m respectively on the frequency of COPD-E was estimated using a zero-truncated negative binomial model adjusted for potential confounders. Goodness-of-fit was assessed by residuals.
During the observation period, 580 COPD-E occurred in 722 patients. Significant associations were found between COPD-E and NO concentrations ≥25 µg/m (incidence density ratio, RDI: 1.29, 95% CI: 1.02-1.67) after adjustment for sun exposure, COPD severity, depression, and ambient humidity. No association was found between the frequency of COPD-E and PM concentrations ≥15µg/m.
Prolonged exposure to high levels of NO increases the frequency of COPD exacerbations in patients residing in Bogotá. These results highlight the importance of strengthening air quality control measures and educating people with COPD to know and interpret the local air quality indices and to follow the recommendations derived from its alterations.
慢性阻塞性肺疾病急性加重（COPD-E）与空气污染水平相关。COPD-E的发生与该人群死亡率增加有关。
确定长期暴露于细颗粒物（PM）和氮氧化物（NO）与哥伦比亚波哥大AIREPOC机构性慢性阻塞性肺疾病综合护理项目中患者的COPD-E发作频率之间的关联。
回顾性队列研究纳入了2018年至2021年期间居住在波哥大且在AIREPOC项目中接受医疗护理的慢性阻塞性肺疾病患者。确定了每位患者的家庭住址地理位置。利用当地空气质量监测站的信息，采用距离平方反比加权回归（IDWR）方法估算每位患者的每日和年度平均PM及NO暴露水平。分别以15μg/m³和25μg/m³为分类标准的PM和NO浓度对COPD-E发作频率的影响，采用针对潜在混杂因素进行调整的零截断负二项式模型进行估算。通过残差评估拟合优度。
在观察期内，722例患者发生了580次COPD-E发作。在对日照、慢性阻塞性肺疾病严重程度、抑郁和环境湿度进行调整后，发现COPD-E与NO浓度≥25μg/m³之间存在显著关联（发病密度比，RDI：1.29，95%置信区间：1.02-1.67）。未发现COPD-E发作频率与PM浓度≥15μg/m³之间存在关联。
长期暴露于高水平的NO会增加居住在波哥大的患者慢性阻塞性肺疾病急性加重的频率。这些结果凸显了加强空气质量控制措施以及教育慢性阻塞性肺疾病患者了解和解读当地空气质量指数并遵循因其变化而得出的建议的重要性。
