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目的分析研究重度慢性阻塞性肺疾病(COPD)患者频繁急性加重的危险因素。方法采用病例对照研究方法分析230例GOLD 3-4级患者1秒用力呼气容积(FEV1)<50%预计值的临床资料。其中,109例每年有2次以上中度-重度急性加重发作。多因素Logistic回归分析确定导致重度COPD频繁急性加重的临床预测因子。结果多因素Logistic回归分析结果显示,哮喘病史、用力呼出气量为25%-75%肺活量时的平均流量(FEF 25%-75%)预计值下降、呼吸困难程度指数(mMRC)及C-反应蛋白(CRP)增高均与重度COPD频繁急性加重密切相关。结论哮喘病史、FEF25%-75%预计值降低、mMRC及CRP增高是重度COPD频繁急性加重的临床预测因子。
Objective To analyze the risk factors of frequent acute exacerbations in patients with severe chronic obstructive pulmonary disease (COPD). Methods The clinical data of <50% predicted value of forced expiratory volume in one second (FEV1) of 230 patients with GOLD level 3-4 were analyzed by case-control study. Of these, 109 patients had more than 2 moderate-severe exacerbations each year. Multivariate Logistic regression analysis identified clinical predictors of frequent acute exacerbations of severe COPD. Results Multivariate logistic regression analysis showed that the predicted decline in asthma history, mean expiratory volume at forced expiratory volume of 25% -75% (FEF 25% -75%), dysmnesia index (mMRC) and C-reactive protein (CRP) increased with severe acute exacerbations of COPD are closely related. Conclusions The history of asthma, FEF25% -75% decrease, mMRC and CRP increase are the frequent predictors of severe acute exacerbation of COPD.