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学科主题: 临床医学
题名:
The clinical impact of non-obstructive chronic bronchitis in current and former smokers
作者: Martinez, Carlos H.1; Kim, Victor2; Chen, Yahong3; Kazerooni, Ella A.4; Murray, Susan5; Criner, Gerard J.2; Curtis, Jeffrey L.1,6; Regan, Elizabeth A.7; Wan, Emily8,9; Hersh, Craig P.8,9; Silverman, Edwin K.8,9; Crapo, James D.7; Martinez, Fernando J.1; Han, MeiLan K.1; COPDGene Investigators
关键词: Cough ; Quality of life ; Gastroesophageal reflux ; Occupational exposure ; GERD ; Tobacco
刊名: RESPIRATORY MEDICINE
发表日期: 2014-03-01
DOI: 10.1016/j.rmed.2013.11.003
卷: 108, 期:3, 页:491-499
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Cardiac & Cardiovascular Systems ; Respiratory System
研究领域[WOS]: Cardiovascular System & Cardiology ; Respiratory System
关键词[WOS]: OBSTRUCTIVE PULMONARY-DISEASE ; QUALITY-OF-LIFE ; IMPORTANT DIFFERENCE ; SLEEP-APNEA ; RESPIRATORY QUESTIONNAIRE ; GENERAL-POPULATION ; YOUNG-ADULTS ; LUNG-CANCER ; COPD ; SYMPTOMS
英文摘要:

Background: As the clinical significance of chronic bronchitis among smokers without airflow obstruction is unclear, we sought to determine morbidity associated with this disorder.

Methods: We examined subjects from the COPDGene study and compared those with FEV1 /FVC >= 0.70, no diagnosis of asthma and chronic bronchitis as defined as a history of cough and phlegm production for >= 3 months/year for >= 2 years (NCB) to non-obstructed subjects without chronic bronchitis (CB-). Multivariate analysis was used to determine factors associated with and impact of NCB.

Results: We identified 597 NCB and 4283 CB-subjects. NCB participants were younger (55.4 vs. 57.2 years, p < 0.001) with greater tobacco exposure (42.9 vs. 37.8 pack-years, p < 0.001) and more often current smokers; more frequently reported occupational exposure to fumes (52.8% vs. 42.2%, p < 0.001), dust for >= 1 year (55.3% vs. 42.0%, p < 0.001) and were less likely to be currently working. NCB subjects demonstrated worse quality-of-life (SGRQ 35.6 vs. 15.1, p < 0.001) and exercise capacity (walk distance 415 vs. 449 m, p < 0.001) and more frequently reported respiratory "flareups" requiring treatment with antibiotics or steroids (0.30 vs. 0.10 annual events/subject, p < 0.001) prior to enrollment and during follow-up (0.34 vs. 0.16 annual events/subject, p < 0.001). In multivariate analysis, current smoking, GERD, sleep apnea and occupational exposures were significantly associated with NCB.

Conclusions: While longitudinal data will be needed to determine whether NCB progresses to COPD, NCB patients have poorer quality-of-life, exercise capacity and frequent respiratory events. Beyond smoking cessation interventions, further research is warranted to determine the benefit of other therapeutics in this population. (C) 2013 Elsevier Ltd. All rights reserved.

语种: 英语
所属项目编号: U01HL089897 ; U01Hl089856 ; K23 HL093351 ; T32 HL007749-20 ; R01NR013377
项目资助者: NHLBI ; Biomedical Laboratory Research &amp ; Development Service, Department of Veterans Affairs ; NIH NHLBI ; NHLLBI
WOS记录号: WOS:000333489100009
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/64802
Appears in Collections:北京大学第三临床医学院_呼吸内科_期刊论文

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作者单位: 1.Univ Michigan Hlth Syst, Pulm & Crit Care Div, Ann Arbor, MI 48109 USA
2.Temple Univ, Sch Med, Div Pulm & Crit Care, Philadelphia, PA 19122 USA
3.Peking Univ, Resp Dept, Hosp 3, Beijing 100871, Peoples R China
4.VA Healthcare Syst, Med Serv, Ann Arbor, MI USA
5.Natl Jewish Med & Res Ctr, Dept Med, Denver, CO USA
6.Univ Michigan, Dept Radiol, Ann Arbor, MI 48109 USA
7.Univ Michigan, Sch Publ Hlth, Ann Arbor, MI 48109 USA
8.Brigham & Womens Hosp, Channing Div Network Med, Boston, MA 02115 USA
9.Brigham & Womens Hosp, Pulm & Crit Care Div, Boston, MA 02115 USA

Recommended Citation:
Martinez, Carlos H.,Kim, Victor,Chen, Yahong,et al. The clinical impact of non-obstructive chronic bronchitis in current and former smokers[J]. RESPIRATORY MEDICINE,2014,108(3):491-499.
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