慢性阻塞性肺疾病患者病情加重与昼夜节律的相关性

The relationship between the disease exacerbations and circadian rhythms in patients with COPD

目的：探讨慢性阻塞性肺疾病（COPD）患者病情加重与昼夜节律的相关性。方法：对154例COPD患者随访3年,记录患者的一般情况和病情加重的情况,分析吸烟、年龄和性别与COPD病情加重和昼夜节律的相关性。结果：154例患者共出现急性加重次数1 401次,其中觉醒型512次（36.5%）,睡眠型889次（63.5%）。其中82例为睡眠型COPD急性加重患者（53.2%）,32例为觉醒型COPD急性加重患者（20.8%）,40例为弥散型COPD急性加重患者（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易出现COPD夜间病情加重（P〈0.05-P〈0.01）。结论：COPD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 investigate the relationships between the disease exacerbations and circadian rhythms in patients with chronic obstructive pulmonary disease（ COPD）. Methods： One hundred and fifty-four patients with COPD were followed up for 3 years.The general condition and exacerbations situation in all patients were recorded. The relationships between smoking,age,sexuality,circadian rhythms and disease exacerbations were analyzed. Results： The acute exacerbation times in 154 cases were 1 401 times,which included the 512 times of awakening type（ 36. 5%） and 889 times of sleep type（ 63. 5%）. One hundred and fifty-four cases included the acute exacerbation sleep type COPD in 82 cases（ 53. 2%）,acute exacerbation awakening type COPD in 32 cases（ 20. 8%） and acute exacerbation diffuse type COPD in 40 cases（ 26. 0%）. The exacerbations COPD in night was most likely to occur in patients with more than or equal to 70 years,smoking male with less than or equal to 70 years and non-smoking female（ P〈0. 05 to P〈0. 01）.Conclusions： The exacerbations of COPD exists the circadian rhythms,the occurrence of which is prone to at night,in sleep type patients,and especially for smoking old male.