慢性阻塞性肺疾病患者病情加重与昼夜节律的相关性

Association of circadian rhythm to acute exacerbation of chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病(简称慢阻肺)患者病情加重与昼夜节律的相关性。方法对154例慢阻肺患者随访3年,记录每位患者的一般情况和病情加重的情况,分析吸烟、年龄、性别与慢阻肺病情加重昼夜节律的相关性。结果 154例患者共出现急性加重次数1401次,觉醒型512次(36.5%),睡眠型889次(63.5%)。其中82例为睡眠型慢阻肺急性加重患者(53.2%),32例为觉醒型慢阻肺急性加重患者(20.8%),40例为弥散型慢阻肺急性加重(26.0%)。高龄(≥70岁)、吸烟和男性均较低龄(<70岁)、非吸烟和女性患者更容易出现夜间病情加重(P<0.05)。结论慢阻肺患者病情加重存在昼夜节律性,病情恶化更容易出现在夜间,睡眠型加重患者更为多见,尤其是吸烟、高龄男性。

Objective To explore the association of circadian rhythm to acute exacerbation of chronic obstructive pulmonary disease. Methods 154 patients with COPD were selected and followed up for 3 years. The general condition of patients and the times of exacerbation were recorded. The association of smoking, age and gender to circadian rhythm exacerbation was analyzed. Results There were a total of 1401 times of acute exacerbation in 154 COPD patients, including 512 times （36. 5%） occurred from 6 am to 10 pm, and 889 times （63. 5%） from 10 pm to 6 am in the next morning. 82 cases belonged to sleep-type exacerbation of COPD, 32 cases to awake-type, and 40 cases to diffusing-type. The incidence of circadian rhythm exacerbation was obviously higher in elderly patients （≥70 years old） , smokers and male patients than in relatively young patients （ 〈70 years old） , non-smokers and female patients （P〈0. 05）. Conclusion The exacerbation shows circadian rhythm in patients with COPD, which is more likely to occur at night, especially in those smokers, elderly and male patients.