Qian Yang, Sun Chao, Zhang Liang, Cai Chenting, Sun Mengqing, Zhang Jiaqian, Huang Jian, Ma Hongying, Tan Lin, Zhao Yun, Wang Shanshan, Lv Dan
The First Affiliated Hospital of Ningbo University, Ningbo, 315010, People's Republic of China.
Ningbo Municipal Center for Disease Control and Prevention, Ningbo, 315000, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2025 Aug 8;20:2787-2799. doi: 10.2147/COPD.S510906. eCollection 2025.
To understand the high-risk factors for disease progression in patients in the chronic obstructive pulmonary disease (COPD) group E in Ningbo, and to explore the impact of and treatment on the prognosis of these patients.
We retrospectively analyzed the clinical data of 101 COPD patients in terms of general demographics, physical baseline data, lung function, disease treatment, and prognosis and used crosstab analysis and logistic regression analysis to understand the characteristics of the population of patients at high risk of acute exacerbation of COPD (AECOPD) and the associated risk factors.
Univariate analysis demonstrated that frequent acute exacerbation (AE) in the COPD group E population was significantly associated with more severe airflow limitation, a lower FEF75%, higher mMRC scores, and irregular disease management (P<0.05). Comorbid cardiovascular disease increased AE risk 4.138-fold (P<0.05). Multivariate analysis confirmed that irregular disease review, cardiovascular comorbidity, and mMRC grades 3-4 were risk factors (P<0.05). Regular review reduced AE risk, while cardiovascular disease and mMRC grades 3-4 increased the risk 8.802-fold and 12.327-fold, respectively.
The severity of airflow restriction, instantaneous flow during forced exhalation of 75% of the lung capacity, cardiovascular disease complexity, higher mMRC scores, and irregular participation in intervention treatment were associated with disease deterioration in patients at high risk of AECOPD. Regular participation in standardized intervention management and treatment is a protective factor against worsening events in high-risk patients with AECOPD. These results may reduce medical resource utilization and AE frequency while improving quality of life, thereby informing evidence-based COPD management strategies and optimizing chronic disease care and resource allocation.
了解宁波市慢性阻塞性肺疾病（COPD）E组患者疾病进展的高危因素，探讨其对这些患者预后的影响及治疗措施。
我们回顾性分析了101例COPD患者的临床资料，内容包括一般人口统计学、身体基线数据、肺功能、疾病治疗及预后，并采用交叉表分析和逻辑回归分析来了解慢性阻塞性肺疾病急性加重（AECOPD）高危患者群体的特征及相关危险因素。
单因素分析表明，COPD E组人群频繁急性加重（AE）与更严重的气流受限、更低的第75%用力呼气流量（FEF75%）、更高的改良英国医学研究委员会（mMRC）评分以及不规律的疾病管理显著相关（P<0.05）。合并心血管疾病使AE风险增加4.138倍（P<0.05）。多因素分析证实，不规律的疾病复查、心血管合并症以及mMRC 3 - 4级是危险因素（P<0.05）。定期复查可降低AE风险，而心血管疾病和mMRC 3 - 4级分别使风险增加8.802倍和12.327倍。
气流受限的严重程度、肺容量75%时用力呼气的瞬间流量、心血管疾病的复杂性、更高的mMRC评分以及不规律参与干预治疗与AECOPD高危患者的疾病恶化相关。定期参与标准化干预管理和治疗是预防AECOPD高危患者病情恶化事件的保护因素。这些结果可能会减少医疗资源的利用和AE发生频率，同时提高生活质量，从而为基于证据的COPD管理策略提供依据，并优化慢性病护理和资源分配。
