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Clinical Significance of Symptoms in Smokers with Preserved Pulmonary Function

Prescott G. Woodruff ... 呼吸系统疾病 • 2016.05.12
• 遗传危险、坚持健康生活方式和冠心病之间的关系






我们进行了一项观察性研究,纳入了现时吸烟者或既往吸烟者,以从未吸烟者作为对照,共计2,736人。我们使用COPD评估测试(COPD Assessment Test,CAT,评分范围为0~40分,分数较高表示症状较严重)测量了他们的呼吸道症状。我们评价了保留肺功能(使用支气管扩张剂后进行呼吸量测定,FEV1∶FVC≥0.70,同时FVC大于正常范围下限)同时存在呼吸道症状(CAT评分≥10分)的现时吸烟者和既往吸烟者是否比保留肺功能但没有呼吸道症状(CAT评分<10分)的现时吸烟者和既往吸烟者出现呼吸道症状加重的风险更高,以及这两组人群在6分钟步行距离测试、肺功能或胸部高分辨率计算机断层扫描(HRCT)方面是否有不同的结果。






虽然保留肺功能,有症状的现时吸烟者或既往吸烟者还未达到当前COPD的诊断标准,但是他们存在呼吸道症状加重、活动受限并且有气道疾病出现的迹象。他们在没有任何临床证据的情况下使用着一系列的呼吸系统药物(由美国国立心肺血液研究所[National Heart, Lung, and Blood Institute]、国立卫生研究院基金会[Foundation for the National Institutes of Health]资助;SPIROMICS在ClinicalTrials.gov注册号为NCT01969344)。


Prescott G. Woodruff, M.D., R. Graham Barr, M.D., Dr.P.H., Eugene Bleecker, M.D., Stephanie A. Christenson, M.D., David Couper, Ph.D., Jeffrey L. Curtis, M.D., Natalia A. Gouskova, Ph.D., Nadia N. Hansel, M.D., Eric A. Hoffman, Ph.D., Richard E. Kanner, M.D., Eric Kleerup, M.D., Stephen C. Lazarus, M.D., Fernando J. Martinez, M.D., Robert Paine, III, M.D., Stephen Rennard, M.D., Donald P. Tashkin, M.D., and MeiLan K. Han, M.D., for the SPIROMICS Research Group*
From the Cardiovascular Research Institute (P.G.W., S.C.L.) and the Department of Medicine, Division of Pulmonary, Critical Care, Sleep, and Allergy (P.G.W., S.A.C., S.C.L.), University of California at San Francisco, San Francisco; the Departments of Medicine and Epidemiology, Columbia University Medical Center (R.G.B.), and the Department of Medicine, Weill–Cornell Medical College (F.J.M.) — both in New York; the Department of Medicine, Center for Genomics and Personalized Medicine Research, Wake Forest University, Winston-Salem (E.B.), and the Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill (D.C., N.A.G.) — both in North Carolina; the Section of Pulmonary and Critical Care Medicine, Medical Service, Veterans Affairs Ann Arbor Healthcare System (J.L.C.), and the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan (J.L.C., M.K.H.) — both in Ann Arbor; the Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore (N.N.H.); the Department of Radiology, University of Iowa Carver College of Medicine, Iowa City (E.A.H.); the Department of Medicine, University of Utah Hospitals and Clinics, Salt Lake City (R.E.K., R.P.); the Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles (E.K., D.P.T.); the Department of Medicine, University of Nebraska Medical Center, Omaha (S.R.); and the Clinical Discovery Unit, AstraZeneca, Cambridge, United Kingdom (S.R.).Address reprint requests to Dr. Woodruff at the University of California at San Francisco, Box 0130, Rm. HSE 1305, 513 Parnassus Ave., San Francisco, CA 94143, or at prescott.woodruff@ucsf.edu. *A complete list of the investigators in the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) is provided in the Supplementary Appendix, available at NEJM.org.



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