COPD prevalence in 12 Asia-Pacific countries and regions: projections based on the COPD prevalence estimation model

Objective:   COPD is a leading cause of mortality and morbidity worldwide. Despite the high rates of cigarette smoking, and the wide use of biomass fuels, there is very little objective data on the prevalence of COPD in Asia.
Methodology:   We used a COPD prevalence model to estimate the prevalence of COPD in 12 Asian countries. This model is a validated, computerized tool that uses epidemiological relationships and risk factor prevalence to project the prevalence of COPD within a given population aged 30 years and older.
Results:   The total number of moderate to severe COPD cases in the 12 countries of this region, as projected by the model, is 56.6 million with an overall prevalence rate of 6.3%. The COPD prevalence rates for the individual countries range from 3.5% (Hong Kong and Singapore) to 6.7% (Vietnam).
Conclusions:   The COPD prevalence rates projected by the model reflect the high prevalence of the risk factors for the disease in Asia. The combined prevalence of 6.3% for these countries is considerably higher than the overall rate of 3.8% as extrapolated from WHO data for this region. These estimates highlight the need for further epidemiological studies to support appropriate allocation of resources for the prevention and management of COPD.     

孟鲁司特钠联合氢化可的松琥珀酸钠治疗小儿喘息性支气管炎的疗效观察

目的探讨孟鲁司特纳联合氢化可的松琥珀酸钠治疗小儿喘息性支气管炎的疗效及其对患儿预后的影响。方法将124例喘息性支气管炎患儿随机分为观察组及对照组,每组各62例。对照组患儿静脉滴注氢化可的松琥珀酸钠5~10mg/kg·d,疗程1周;观察组在对照组基础上口服孟鲁司特钠,4毫克/次,1次/天,疗程2~3周。对比分析两组临床症状改善情况并在1个月内电话随访。结果观察组总有效率为96.77%,对照组总有效率为80.64%,两组比较差异有统计学意义(P0.05);观察组治疗后咳嗽、气促、哮鸣音症状评分与治疗前相比明显下降,且观察组下降幅度大于对照组(P0.05);观察组治疗后3个月内电话及门诊随访复发率明显低于对照组,差异有统计学意义(P0.05)。结论孟鲁司特纳联合氢化可的松琥珀酸钠能有效改善喘息性支气管炎患儿临床症状,改善预后,降低复发率,提高患儿治疗效果。     

Prevalence and determinants of self-reported chronic bronchitis among women in rural Central India

Background

Chronic respiratory conditions are increasingly becoming a cause of health concern with India attributing 11% of its mortality due to non-communicable diseases to chronic respiratory conditions. Chronic bronchitis and asthma take a large toll in terms of morbidity. Lesser number of studies have mentioned their counts of these conditions affecting women in rural area and therefore the present study was conducted with the objectives of determining the prevalence and correlates of chronic obstructive pulmonary diseases (COPD) in an area of a primary health centre in rural central India.

Methods

A cross-sectional study was conducted in 24 villages of the study area. Women aged 40 years or more were interviewed using the IUATLD questionnaire. Chronic bronchitis was measured by using the standard criteria for chronic bronchitis, that is, “Presence of cough with expectoration for more than 3 months in a year for the past two or more years”.

Results

Prevalence of chronic bronchitis among women was found to be 2.7%. Factors like older age, presence of a cattle shed within house premises, storage of fertilizers inside house, history of allergy, past history of pulmonary tuberculosis emerged as significant correlates of chronic bronchitis.

Conclusions

The present study provides an insight into the prevalence of chronic bronchitis among rural women exposed to several epidemiological determinants and an opportunity to address the modifiable risk factors.     

热毒宁注射液联合如意金黄散穴位贴敷治疗毛细支气管炎的护理

目的：观察热毒宁注射液联合如意金黄散穴位贴敷治疗毛细支气管炎的护理方法。方法选择我院2014年1—12月毛细支气管炎患儿53例,在常规治疗的基础上给予热毒宁注射液联合如意金黄散穴位贴敷治疗,并于治疗前、中、后给予个性化护理,观察患儿憋消失时间、啰音消失时间、气促缓解时间及平均住院时间和不良反应。结果观察组喘憋消失时间、啰音消失时间、气促缓解时间及平均住院时间均短于对照组,两组比较差异具有显著性（P＜0．05）。两组并发症和不良反应比较差异无显著性（χ2＝0．6321,P＞0．05）。结论热毒宁注射液联合如意金黄散穴位贴敷起效快,作用明显,是治疗毛细支气管炎的有效方法,耐心优质的护理是治疗顺利完成的前提。     

Postural abnormalities in phenotypes of chronic obstructive pulmonary disease

BackgroundFew studies have demonstrated postural abnormalities in patients with chronic obstructive pulmonary disease - when compared with healthy individuals. However, none of these studies have compared postural abnormalities in different phenotypes of chronic obstructive pulmonary disease.ObjectiveTo compare the thoracic posture between two phenotypes of chronic obstructive pulmonary disease (emphysema and chronic bronchitis) with healthy individuals.MethodsForty individuals with chronic obstructive pulmonary disease (20 with chronic bronchitis, 67 ± 3.5 years, 20 with emphysema, 67.7 ± 4 years) and 20 age-matched healthy individuals (67.3 ± 3.9 years) underwent postural assessment which was performed using photogrammetric measurements of head protraction, shoulder protraction, thoracic kyphosis angle, coronal shoulder angle, and scapular elevation.ResultsSignificant differences were found amongst the groups in protraction of head (emphysema vs. chronic bronchitis, mean difference = 7.63°, 95% confidence interval [CI] = 2.10, 13.15°; emphysema vs. healthy, 7.91°, 95% CI = 2.38, 13.43°), protraction of shoulder (emphysema vs. healthy, 13.69°, 95% CI = 6.96, 20.43°; chronic bronchitis vs. healthy, 8.11°, 95% CI = 1.38, 14.85°), thoracic kyphosis (emphysema vs. healthy, −11.59°, 95% CI = −17.26, −5.92°; chronic bronchitis vs. healthy, −6.75°, 95% CI = −12.41, −1.08°), coronal shoulder angle (emphysema vs. chronic bronchitis, 1.01°, 95% CI = .22, 1.80°; emphysema vs. healthy, 1.59°, 95% CI = .80, 2.38°) and scapular elevation (emphysema vs. chronic bronchitis, =.74 cm, 95% CI = .34, 1.15 cm; emphysema vs. healthy, .99 cm, 95% CI = .59, 1.40 cm).ConclusionPeople with emphysema show greater degree of postural malalignments in terms of head and shoulder protraction, thoracic kyphosis, symmetry of shoulders and scapular elevation than patients with chronic bronchitis and age-matched healthy individuals. These observations emphasize the importance of postural assessment in individuals with chronic obstructive pulmonary disease, particularly if they are emphysematous.     

激素敏感性咳嗽和非激素敏感性咳嗽的临床特征分析

目的 探讨激素敏感性咳嗽（CSRC）和非激素敏感性咳嗽（NCSRC）的临床特征差异.方法 收集2003年至2013年在广州医科大学第一附属医院呼吸科就诊的病因明确的357例慢性咳嗽患者的临床资料,进行回顾性分析.依据病因分为激素敏感性咳嗽组和非激素敏感性咳嗽组,将两组的临床特征进行比较.结果 与非激素敏感性患者相比,激素敏感性咳嗽患者的咳嗽病程更短（24 vs.36个月,P=0.025）,CSRC组日间咳嗽积分更低（P＜0.05）.NCSRC组的咳嗽常于白天出现（87.85％ vs.78.15％,P=0.006）,而CSRC组的咳嗽则常出现于夜间（43.13％ vs.32.60％,P=0.018）.与NCSRC组相比,CSRC组胃食管反流症状的发生率更低（26.33％ vs.54.14％,P=0.000）,咳嗽与饮食相关的比例更低（11.43％ vs.37.08％,P=0.000）,伴有鼻部症状的比例更低（40.06％ vs.55.8％,P=0.001）,气促的比例更高（18.21％ vs.11.05％,P=0.032）.感冒和讲话引起咳嗽或咳嗽加重的比例均为NCSRC组高于CSRC组（48.62％ vs.38.94％,28.73％ vs.17.65％,P均＜0.05）.CSRC组咽部异物感、频繁清喉和咽喉壁黏液附着感的比例显著低于NCSRC组（分别为8.68％ vs.18.23％,20.73％ vs.40.88％,3.64％ vs.10.50％,P均＜0.01）.CSRC组的MMEF/pred显著低于NCSRC组（72.29±31.22vs.84.09±31.64,p=0.000）,且气道高反应性的比例高于NCSRC组（29.9％ vs.4.26％）.CSRC组中痰嗜酸粒细胞百分比明显高于NCSRC组（中位数5％ vs.0.25％,P=0.001）.结论 激素敏感性咳嗽和非激素敏感性咳嗽的临床特征存在一定差异,但单纯从临床特征上无法完全区分二者,仍需结合相关实验室检查来明确诊断.     

80例0-3岁毛细支气管炎患儿临床病例分析

目的分析0~3岁毛细支气管炎患儿发病的临床特点,为临床诊断与治疗提供依据。方法对2011年6月—2013年6月惠州市第一妇幼保健院收治确诊为毛细支气管炎80例患儿的临床资料进行回顾,对患儿流行病学资料、临床表现、症状、体征及辅助检查等内容进行统计学分析。结果毛细支气管炎疾病多发于冬春季;症状以咳嗽、喘憋及肺部听诊哮鸣音为主,占发病人群的100%;痰培养显示细菌感染率为33.7%,肺炎支原体感染率为13.7%;抗菌药物仅限制应用于痰培养显示阳性的患儿,临床治疗药物主要以糖皮质激素激素联合β2受体激动剂为基础,并进行对症治疗。结论 0~3岁毛细支气管炎患儿发病具有季节性规律,且临床症状以咳嗽、喘憋及肺部听诊哮鸣音为主,应密切分析感染类型,为合理用药提供依据。     

口服骨化三醇对喘息性支气管炎患儿血清中IgE、IL-12水平的影响

目的：通过监测口服骨化三醇的喘息性支气管炎患儿血清中IgE、IL-12水平,了解补充维生素D对喘息性支气管炎患儿的辅助治疗作用。方法喘息性支气管炎组（简称喘支组）36例,肺炎组33例,健康对照组28例,监测口服应用骨化三醇4周前后血清IgE、IL-12水平。结果口服骨化三醇前,三组血清IgE水平比较结果为：喘支组明显高于肺炎组、对照组,肺炎组与对照组比较无统计学差异;IL-12水平比较结果为：喘支组明显低于肺炎组、对照组,肺炎组与对照组比较无统计学差异。口服4周后,IgE水平：喘支组明显低于肺炎组、对照组,后两组无统计学差异;IL-12水平：喘支组明显高于肺炎组、对照组,后两组无统计学差异。结论骨化三醇可能通过调节IgE、IL-12水平达到对喘息性支气管炎的一定治疗作用。