Background Obesity is the most common metabolic disease in the world. However, the relationship between obesity and lung function is not fully understood. Although several longitudinal studies have shown that increase...Background Obesity is the most common metabolic disease in the world. However, the relationship between obesity and lung function is not fully understood. Although several longitudinal studies have shown that increases in body weight can lead to reductions in pulmonary function, whether this is the case with the Japanese population and whether high body mass index （BMI） status alone represents an appropriate predictor of obstructive lung dysfunction remains unclear.The purpose of present study was to estimate the effect of BMI on lung function measured by spirometry of Japanese patients in general clinics. We measured BMI and performed spirometry on screening patients who had consulted general clinics.Methods Subjects comprised 1231 patients ≥40 years of age （mean age （65.0±12.0） years, 525 men, 706 women） who had consulted clinics in Nagasaki Prefecture, Japan, for non-respiratory disease. BMI was calculated and lung function was measured by spirometry.Results BMI was found to be positively correlated with forced expiratory volume in 1 second （FEV1）/forced vital capacity （FVC） in men and with maximum mid-expiratory flow （MMF） in all subjects. Following adjustment for relevant factors, a significant positive correlation between BMI and FEV1/FVC was identified for all subjects. Comparison between subjects with normal BMI （18.5-25.0） and higher BMI （25.1-30.0） also demonstrated that FEV1/FVC and percentage of predicted maximum mid-expiratory flow （%MMF） were significantly higher in the latter subjects.Conclusions In a population without marked respiratory disease, higher BMI subjects showed less obstructive pulmonary dysfunction compared to normal BMI subjects. High BMI status alone may be inappropriate as a predictor of obstructive lung dysfunction, particularly in populations with a low prevalence of obesity.展开更多
BACKGROUND The prevalence of depression in patients with chronic obstructive pulmonary disease(COPD)ranges from 10%to 42%,but the diagnosis of depression in patients with COPD is often unrecognized and untreated.Unrec...BACKGROUND The prevalence of depression in patients with chronic obstructive pulmonary disease(COPD)ranges from 10%to 42%,but the diagnosis of depression in patients with COPD is often unrecognized and untreated.Unrecognized depression has major implications for compliance with medical treatment,prolonged lengths of stay,increased frequency of hospital admissions,and increased consultations with primary care physicians.Many studies have attempted to identify risk factors for progression,prognosis and response to therapy in patients with depression.However,few studies have examined the risk factors for depression in patients with COPD,and some results remain controversial.AIM To identify the potential risk factors to define patients with COPD who are at“high risk”of depression.METHODS The clinical data of 293 patients with COPD were reviewed from January 2017 to December 2018.The correlations between demographics,clinical characteristics and depression were analyzed.The risk factors for depression in patients with COPD were identified by multivariate logistic regression analysis.The cutoff value,sensitivity and specificity of the independent correlation factors were calculated with a receiver operating characteristic curve.RESULTS Of the 293 patients included,65(22.18%)individuals were identified to have depression.Significant differences were detected between patients with and without depression in terms of body mass index(BMI),forced expiratory volume in 1 s(FEV1),and COPD assessment test(CAT)score(all P<0.05).Low BMI,low FEV1,and high CAT were independent risk factors for depression in patients with COPD and the cutoff values of BMI,FEV1,and CAT scores were 21.373 kg/m2,0.855 L and 12.5,respectively.CONCLUSION Low BMI,low FEV1,and high CAT score were identified as independent risk factors for depression in patients with COPD.展开更多
Exercise-Induced bronchoconstriction (EIB) is related to increased ventilation (VE) during exercise and describes the transient airway narrowing following exercise. A reliable diagnosis is essential for optimal treatm...Exercise-Induced bronchoconstriction (EIB) is related to increased ventilation (VE) during exercise and describes the transient airway narrowing following exercise. A reliable diagnosis is essential for optimal treatment. The impact of a repeated exercise challenge test (ECT) in a clinical setting is not well established and conducting a repeated ECT with the possibility to adjust the exercise intensity on an individual basis may give more information. The aim of the study was to evaluate the test-retest reliability of an ECT for EIB and its association with exercise intensity. Methods: After examination by a pulmonologist, 20 referred subjects with symptoms strong indications of Exercise-Induced bronchoconstriction performed two consecutive exercise challenge tests on a treadmill. The exercise intensity of the repeated test was adjusted. Forced expiratory volume in 1 second (FEV1) was measured before and 1, 3, 6, 10, and 15 minutes after exercise. EIB was defined as a reduction of ≥ 10% in FEV1. Ventilation and heart rate were measured during exercise. Results: Five subjects tested positive in both tests, and ten subjects tested negative in both tests. Three subjects tested positive in the first test only, while two subjects tested positive in the second test only. The exercise intensity was not significantly different between the two tests for any of the subjects. Conclusion: There were 25% divergences in the diagnostic results of two consecutive exercise challenge tests. The difference in the test results was not explained by a difference in the exercise intensity.展开更多
目的·探讨通过胸部CT计算得到的低衰减区比例(ratio of low attenuation areas,LAA%)及肺容积对评估肺通气功能受损程度的临床价值。方法·回顾性纳入2010年1月—2014年7月在上海交通大学医学院附属瑞金医院同期完成胸部CT和...目的·探讨通过胸部CT计算得到的低衰减区比例(ratio of low attenuation areas,LAA%)及肺容积对评估肺通气功能受损程度的临床价值。方法·回顾性纳入2010年1月—2014年7月在上海交通大学医学院附属瑞金医院同期完成胸部CT和肺通气功能检查的患者,用Myrian软件自动计算LAA%及肺容积,与舒张后第1秒用力呼气容积(forced expiratory volume in 1 second,FEV1)及其占预计值百分比(FEV1%pred)进行相关性分析,并纳入患者性别、年龄、身高、体质量建立回归方程。绘制ROC曲线,比较LAA%、肺容积及回归方程所得值在判断肺通气功能受损程度中的价值,根据约登指数和特异度选取界值,验证诊断效能。结果·纳入1150名受试者进入归纳组,LAA%与舒张后FEV1及FEV1%pred呈负相关,肺容积与舒张后FEV1呈正相关。舒张后FEV1的回归方程为:FEV1=-2.700+0.111×肺容积-0.216×ln(LAA%+0.1)-0.025×年龄+0.154×性别+0.034×身高。舒张后FEV1%pred的回归方程为:FEV1%pred=65.582+4.014×肺容积-7.508×ln(LAA%+0.1)-10.264×性别。在判断舒张后FEV1下降程度时,回归方程优于单独使用LAA%和肺容积;在判断舒张后FEV1%pred下降程度时,回归方程和LAA%优于肺容积。LAA%>1.61%用于判断舒张后FEV1%pred<35%的敏感度为75.6%,特异度为90.6%;舒张后FEV1的回归方程计算值<1.76用于判断舒张后FEV1<1 L的敏感度为58.9%,特异度为81.4%。结论·得到了基于胸部CT所示肺容积和LAA%的舒张后FEV1及FEV1%pred的回归方程,LAA%与肺容积可以粗略地估计肺通气功能的受损程度。展开更多
文摘Background Obesity is the most common metabolic disease in the world. However, the relationship between obesity and lung function is not fully understood. Although several longitudinal studies have shown that increases in body weight can lead to reductions in pulmonary function, whether this is the case with the Japanese population and whether high body mass index （BMI） status alone represents an appropriate predictor of obstructive lung dysfunction remains unclear.The purpose of present study was to estimate the effect of BMI on lung function measured by spirometry of Japanese patients in general clinics. We measured BMI and performed spirometry on screening patients who had consulted general clinics.Methods Subjects comprised 1231 patients ≥40 years of age （mean age （65.0±12.0） years, 525 men, 706 women） who had consulted clinics in Nagasaki Prefecture, Japan, for non-respiratory disease. BMI was calculated and lung function was measured by spirometry.Results BMI was found to be positively correlated with forced expiratory volume in 1 second （FEV1）/forced vital capacity （FVC） in men and with maximum mid-expiratory flow （MMF） in all subjects. Following adjustment for relevant factors, a significant positive correlation between BMI and FEV1/FVC was identified for all subjects. Comparison between subjects with normal BMI （18.5-25.0） and higher BMI （25.1-30.0） also demonstrated that FEV1/FVC and percentage of predicted maximum mid-expiratory flow （%MMF） were significantly higher in the latter subjects.Conclusions In a population without marked respiratory disease, higher BMI subjects showed less obstructive pulmonary dysfunction compared to normal BMI subjects. High BMI status alone may be inappropriate as a predictor of obstructive lung dysfunction, particularly in populations with a low prevalence of obesity.
基金Supported by Horizontal Projects of National Key Research and Development Plan Projects,No.1210053010.
文摘BACKGROUND The prevalence of depression in patients with chronic obstructive pulmonary disease(COPD)ranges from 10%to 42%,but the diagnosis of depression in patients with COPD is often unrecognized and untreated.Unrecognized depression has major implications for compliance with medical treatment,prolonged lengths of stay,increased frequency of hospital admissions,and increased consultations with primary care physicians.Many studies have attempted to identify risk factors for progression,prognosis and response to therapy in patients with depression.However,few studies have examined the risk factors for depression in patients with COPD,and some results remain controversial.AIM To identify the potential risk factors to define patients with COPD who are at“high risk”of depression.METHODS The clinical data of 293 patients with COPD were reviewed from January 2017 to December 2018.The correlations between demographics,clinical characteristics and depression were analyzed.The risk factors for depression in patients with COPD were identified by multivariate logistic regression analysis.The cutoff value,sensitivity and specificity of the independent correlation factors were calculated with a receiver operating characteristic curve.RESULTS Of the 293 patients included,65(22.18%)individuals were identified to have depression.Significant differences were detected between patients with and without depression in terms of body mass index(BMI),forced expiratory volume in 1 s(FEV1),and COPD assessment test(CAT)score(all P<0.05).Low BMI,low FEV1,and high CAT were independent risk factors for depression in patients with COPD and the cutoff values of BMI,FEV1,and CAT scores were 21.373 kg/m2,0.855 L and 12.5,respectively.CONCLUSION Low BMI,low FEV1,and high CAT score were identified as independent risk factors for depression in patients with COPD.
文摘Exercise-Induced bronchoconstriction (EIB) is related to increased ventilation (VE) during exercise and describes the transient airway narrowing following exercise. A reliable diagnosis is essential for optimal treatment. The impact of a repeated exercise challenge test (ECT) in a clinical setting is not well established and conducting a repeated ECT with the possibility to adjust the exercise intensity on an individual basis may give more information. The aim of the study was to evaluate the test-retest reliability of an ECT for EIB and its association with exercise intensity. Methods: After examination by a pulmonologist, 20 referred subjects with symptoms strong indications of Exercise-Induced bronchoconstriction performed two consecutive exercise challenge tests on a treadmill. The exercise intensity of the repeated test was adjusted. Forced expiratory volume in 1 second (FEV1) was measured before and 1, 3, 6, 10, and 15 minutes after exercise. EIB was defined as a reduction of ≥ 10% in FEV1. Ventilation and heart rate were measured during exercise. Results: Five subjects tested positive in both tests, and ten subjects tested negative in both tests. Three subjects tested positive in the first test only, while two subjects tested positive in the second test only. The exercise intensity was not significantly different between the two tests for any of the subjects. Conclusion: There were 25% divergences in the diagnostic results of two consecutive exercise challenge tests. The difference in the test results was not explained by a difference in the exercise intensity.
文摘目的探讨平喘止咳汤治疗对慢阻肺急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者临床疗效及1 s用力呼气容积(forced expiratory volume in1 second,FEV_(1))、1 s用力呼气容积占用力肺活量比值(forced expiratory volume in 1 second to take up forced vital capacity ratio,FEV_(1)%)的影响效果。方法抽选2019年6月—2020年6月在枣阳市中医医院收治住院的108例AECOPD患者,随机数字表法分为对照组与研究组,各54例。对照组应用常规西药治疗,研究组应用平喘止咳汤治疗。对两组患者的临床治疗效果、肺功能改善情况(FEV_(1)、FEV_(1)%)以及不良反应发生率进行比较。结果研究组临床疗效(96.3%)高于对照组(77.8%),差异有统计学意义(P<0.05)。治疗前,两组FEV_(1)、FEV_(1)%比较,差异无统计学意义(P>0.05);研究组治疗后的肺功能优于对照组(P<0.05)。研究组不良反应发生率为5.6%,低于对照组的20.4%,差异有统计学意义(P<0.05)。结论AECOPD患者应用平喘止咳汤治疗,具有显著疗效,使患者的相关肺功能指标得到更加显著改善,降低患者治疗过程中出现相关不良反应的风险与发生率。
