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1.
目的 探讨石家庄市居民慢性阻塞性肺疾病检出情况及影响因素。方法 2021年9—12月采用整群随机抽样方法抽取石家庄市3个社区,对抽中社区的所有居民进行问卷调查和肺功能检查。利用描述流行病学方法分析社区人群慢性阻塞性肺疾病患病现状。应用单、多因素方法分析影响慢性阻塞性肺疾病发生的危险因素。结果 共2 348名居民完成问卷调查和肺功能检查,其中男1 205人,占51.32%,女1 143人,占48.68%,年龄31~76岁。共有146例检出慢性阻塞性肺疾病,检出率为6.22%,其中轻度69例,占47.26%,中度54例,占36.99%,重度23例,占15.75%,未检出极重度者。检出来的症状分布中,以咳嗽及咳痰的比例较高,分别为52.05%(76例)和49.32%(72例)。多因素Logistic回归分析结果显示年龄≥40岁(OR=1.705、1.936)、男性(OR=3.404)、居住在农村(OR=2.469)、偶尔或经常吸烟(OR=1.592、1.800)、有职业粉尘接触史(OR=2.179)、有哮喘家族史(OR=3.164)、有慢性阻塞性肺疾病家族史(OR=5.170)、有呼吸道反复感染史(OR=3.414)是石家庄市居民慢性阻塞性肺病患病的影响因素。结论 石家庄市居民的慢性阻塞性肺疾病患病情况不容乐观,且危险因素众多。重点针对中老年、吸烟、农村、有各种相关家族史的男性高危人群开展早期筛查和采取针对性干预措施,有助于对居民慢性阻塞性肺疾病进行防控。  相似文献   
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BackgroundPatients with chronic obstructive pulmonary disease (COPD) have several comorbidities. Leukoaraiosis (LA) is an abnormal appearance of brain white matter on neuroimaging, and it has been linked to microangiopathy of the brain. In this study, we explored the association between airflow limitation (AL) and LA volume and localization.MethodsThis observational cross-sectional study included 3,945 subjects who underwent medical check-ups between January 2015 and December 2017. LA was automatically assessed and quantified on brain MRI images using a morphometric program. Spirometry without bronchodilator was performed, and AL was defined as the ratio of forced expiratory volume in 1 s/forced vital capacity <0.70.ResultsIn the multivariate analysis, AL was an independent predictor of LA volume (t = 3.06, P < 0.01), in addition to age, hypertension, and dyslipidemia. Compared with the propensity-matched subjects without AL, the subjects with AL (n = 157) had significantly higher LA volumes (4.65 cm3 vs. 3.26 cm3, P < 0.05) and frequency of LA in the frontal lobe, but not in the parietal, temporal, and occipital lobes.ConclusionsOur findings suggest that AL is associated with increased LA volume and with more frequent localization of LA in the frontal lobe.  相似文献   
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The general aim of this study is to create a cohort of asthma patients with varying grades of severity in order to gain greater insight into the mechanisms underlying the genesis and course of this disease.The specific objectives focus on various studies, including imaging, lung function, inflammation, and bronchial hyperresponsiveness, to determine the relevant events that characterize the asthma population, the long-term parameters that can determine changes in the severity of patients, and the treatments that influence disease progression. The study will also seek to identify the causes of exacerbations and how this affects the course of the disease.Patients will be contacted via the outpatient clinics of the 8 participating institutions under the auspices of the Spanish Respiratory Diseases Networking System (CIBER). In the inclusion visit, a standardized clinical history will be obtained, a clinical examination, including blood pressure, body mass index, complete respiratory function tests, and FENO will be performed, and the Asthma Control Test (ACT), Morisky-Green test, Asthma Quality of Life Questionnaire (Mini AQLQ), the Sino-Nasal Outcome Test 22 (SNOT-22), and the Hospital Anxiety and Depression scale (HADS) will be administered. A specific electronic database has been designed for data collection. Exhaled breath condensate, urine and blood samples will also be collected. Non-specific bronchial hyperresponsiveness testing with methacholine will be performed and an induced sputum sample will be collected at the beginning of the study and every 24 months. A skin prick test for airborne allergens and a chest CT will be performed at the beginning of the study and repeated every 5 years.  相似文献   
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BackgroundInspiratory flow limitation is a breathing pattern during sleep caused by upper airway (UA) narrowing that occurs during snoring and various degrees of obstructive sleep apnea (OSA). Clinical examination of flow limitation relies on identifying patterns of airflow contour, however this process is subjective and lacks physiological evidence of UA narrowing. Our objective is to derive the temporal features of nasal airflow contour that characterize flow limitation. The features that correlate with UA narrowing can be used to develop machine learning classifiers to detect flow limitation with physiological support.MethodsSixteen healthy adult men underwent full daytime polysomnography where the nasal airflow was recorded. Before and after sleep, we measured UA anatomical parameters including neck circumference (NC) and upper-airway cross-sectional area (UA-XSA). We extracted various temporal features of airflow and investigated their relationships with the UA anatomical parameters.ResultsWe found that three features were correlated with the anatomical parameters associated with UA narrowing: deviation index vs. baseline UA-XSA (r = −0.67, p = 0.01), peak amplitude variability vs. baseline UA-XSA (r = −0.69, p < 0.01), peak amplitude variability vs. ΔNC (r = 0.74, p < 0.01) and peak number vs. baseline UA-XSA (r = −0.54, p = 0.04).ConclusionsTemporal features of airflow were associated with UA narrowing. Future studies could utilize the features to develop classifiers to detect flow limitation and assess the severity of breathing disorders during sleep in high-risk populations such as pregnant women and children.  相似文献   
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《The Journal of asthma》2013,50(5):456-463
Objective. The relationship between weight status and asthma characteristics in children remains inadequately defined. Very little has been published on the risk of exacerbation, physician perception of severity, and the level controller treatment prescribed to underweight and obese children with asthma in a real-world setting. Methods. We assessed the diagnostic severity, pulmonary function, exacerbation prevalence, and controller treatment level in 10,559 new asthma patients seen at one of four pediatric asthma subspecialty clinics among three BMI groups. Participants were analyzed by body mass index (BMI)-percentile based on Centers for Disease Control & Prevention classification. Multivariable logistic regression models were used to assess the associations between BMI-percentile cohort group and asthma outcomes. Results. Underweight asthmatics were rare (2.5%) relative to obese asthmatics but appeared to have the greatest impairment in forced vital capacity and had the greatest controller treatment burden. Obese asthmatic children made up 26.2% of our cohort and were more likely to have severe disease (odds ratio (OR) 1.40, 95% confidence interval (CI) 1.06–1.85) and airflow obstruction (OR 1.36, 95% CI 1.16–1.59) compared to normal weight asthmatics. Obese asthmatics were not at greater risk for exacerbation (OR 1.41, 95% CI 0.64–3.11) or high treatment burden (OR 1.03, 95% CI 0.83–1.28). Conclusions. Obesity is more common than underweight status among children with asthma. Both underweight and obese children with asthma have worse lung function and asthma-related outcomes compared to similar normal weight children, though the phenotypic characteristics of underweight and obese asthmatics differed considerably.  相似文献   
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《COPD》2013,10(6):400-407
Background: COPD and asthma are common diseases in the U.S. population and can coexist. Our goal was to determine the prevalence of self-reported, physician-diagnosed asthma and COPD in a sample of the U.S. population and their association with lung function impairment and mortality. Methods: We used baseline data from NHANES III and the follow-up mortality data. We used logistic regression and Cox Proportional Hazards models, adjusting for age, sex, race/ethnicity, education level, smoking status, and disease stage. Results: The sample consisted of 15,203 subjects, of whom 4,542 died during the follow-up period. Coexisting COPD and asthma was reported by 357 (2.7%), COPD by 815 (5.3%), and asthma by 709 (5.3%). Subjects with both conditions had a higher proportion of obstruction (30.9%) than those with COPD (24.3%), asthma (13.3%), or no lung disease (5.4%). In survival models adjusting for all factors except baseline lung function, coexisting COPD and asthma had the highest risk for mortality (Hazard Ratio [HR] 1.83, 95% confidence interval [CI] 1.34, 2.49), followed by COPD only (HR 1.44, 95% CI 1.28, 1.62), and asthma only (HR 1.16, 95% CI 0.94, 1.42). These affects were attenuated after controlling for baseline lung function: coexisting asthma and COPD (HR 1.45, 95% CI 1.06, 1.98), COPD only (1.28, 95% CI 1.13, 1.45), and asthma only (HR 1.04, 95% CI 0.85, 1.27). Conclusion: In this analysis, subjects who report coexisting asthma and COPD have a higher risk of obstruction on spirometry and a higher risk of death during follow-up.  相似文献   
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