The clinical characteristics and treatment of patients with chronic obstructive pulmonary disease from year of 2018 to 2021_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

DENG Dingding ¹ , ZHU Jun ¹ , JIANG Aiyun ¹ , XIAO Xiaocui ¹ , JIANG Yun ¹ , WANG Shao ¹ , ZHU Dan ¹ , ZHOU Aiyuan ² , ZENG Yuqin ³ ,  CHEN Ping ³

1. Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Shaoyang University, Shaoyang, Hunan 422001, P. R. China;
2. Department of Pulmonary and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410003, P. R. China;
3. Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P. R.China;

Corresponding?author：

CHEN Ping, Email: pingchen0731@csu.edu.cn

Keywords：

Chronic obstructive pulmonary disease; clinical characteristics; acute exacerbation; treatment; influenza vaccine/pneumonia vaccine

DOI：

10.7507/1671-6205.202210018

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Objective To compare the clinical characteristics and treatment of patients with chronic obstructive pulmonary disease (COPD) in the year of 2018, 2019, 2020, and 2021. Methods A cross-sectional multicenter study was conducted on patients with stable COPD from 13 hospitals of China south area in year of 2018, 2019, 2020 and 2021. The demographic data, pulmonary function, COPD assessment test (CAT), exacerbation in the past year and treatment regimens were collected. Results The CAT scores of the COPD patients in the year of 2018, 2019, 2020 and 2021 were (16.5±6.7), (14.5±6.7), (14.1±6.2) and (13.4±6.6), respectively. The CAT scores decreased year by year (P<0.05). The forced expiratory volume in one second percentage predicted value (FEV₁%pred) of the COPD patients in the year of 2018, 2019, 2020 and 2021 were (52.8±21.4)%, (51.3±19.2)%, (53.4±21.5)% and (56.6±21.7)%, respectively. Compared with year of 2018, the patients in 2019, 2020 and 2021 had higher FEV₁%pred. Compared with year of 2019 and 2020, the patients 2021 had higher FEV₁%pred (P<0.05). The median of exacerbation in the past year of the COPD patients in the year of 2018, 2019, 2020 and 2021 were 1, 1, 0 and 0, respectively. Compared with year of 2018 and 2019, the median of exacerbation in the past year in 2020 and 2021 were lower (P<0.05). The proportion of double [long-acting β2-agonist (LABA)+long-acting muscarinic antagonist (LAMA)] and triple inhaled [LAMA+LABA+ inhaled corticosteroid (ICS)] drugs were 0%, 0.7%, 3.5% and 17.0%, as well as 47.9%, 41.2%, 27.8% and 26.0%. Compared with year of 2018 and 2019, the proportion of double inhaled drugs in 2020 and 2021 was higher, while triple inhaled drugs was lower (P<0.05). In addition, the proportion of influenza vaccine/pneumonia vaccine was 0%, 0.1%, 3.5% and 4.3%, respectively. Compared with year of 2018 and 2019, the proportion of influenza vaccine/pneumonia vaccine in year of 2020 and 2021 was higher (P<0.05). Conclusions Symptoms and exacerbation burden of patients with COPD tend to be less in China in recent years and the time of patients visited hospital tends to move forward. Furthermore, the proportion of patients with double inhaled drugs (LABA+LAMA) increased, while triple inhaled (LAMA+LABA+ICS) decreased. In addition, the proportion of patients vaccinated with influenza/pneumonia is increased but the overall proportion is still low.

Citation： DENG Dingding, ZHU Jun, JIANG Aiyun, XIAO Xiaocui, JIANG Yun, WANG Shao, ZHU Dan, ZHOU Aiyuan, ZENG Yuqin, CHEN Ping. The clinical characteristics and treatment of patients with chronic obstructive pulmonary disease from year of 2018 to 2021. Chinese Journal of Respiratory and Critical Care Medicine, 2023, 22(1): 24-31. doi: 10.7507/1671-6205.202210018 Copy

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22.	王賡, 劉婷, 王發平, 等. 茚達特羅在慢性阻塞性肺疾病中的臨床應用. 中國呼吸與危重監護雜志, 2019, 18(3): 300-304.
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24.	Crockett AJ, Moss JR, Cranston JM, et al. Domicilary oxygen for chronic obstructive pulmonary disease. Cochrane Database Syst Rev, 2000, (2): CD001744.
25.	Aka Aktürk ü, G?rek Dilekta?l? A, ?engül A, et al. Influenza and pneumonia vaccination rates and factors affecting vaccination among patients with chronic obstructive pulmonary disease. Balkan Med J, 2017, 34(3): 206-211.
26.	樊靜, 叢舒, 王寧, 等. 2014-2015年中國40歲及以上慢性阻塞性肺疾病患者肺炎疫苗接種狀況. 中華流行病學雜志, 2020, 41(7): 1028-1033.
27.	劉聰, 彭雅婷, 李靜, 等. 慢性阻塞性肺疾病初診患者流感和肺炎疫苗接種狀況及影響因素: 真實世界橫斷面研究. 中華結核和呼吸雜志, 2022, 45(4): 355-361.

1. Committee. GE. Global initiative for chronic obstructive lung disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease 2020 report [EB/OL]. http://www. goldcopd. org. Last searched on Nov, 2019.
2. De Matteis S, Jarvis D, Darnton A, et al. The occupations at increased risk of COPD: analysis of lifetime job‐histories in the population‐based UK Biobank Cohort. Eur Respir J, 2019, 54(1): 1900186.
3. Wang C, Xu JY, Yang L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study. Lancet, 2018, 391(10131): 1706-1717.
4. 高稚婷, 高曉華, 張鋒英, 等. 支氣管舒張試驗結果不同的慢性阻塞性肺疾病患者的臨床特點. 中國呼吸與危重監護雜志, 2015, 14(3): 264-268.
5. Lee SJ, Yun SS, Ju S, et al. Validity of the GOLD 2017 classification in the prediction of mortality and respiratory hospitalization in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis, 2019, 14: 911-919.
6. 樊靜, 王寧, 方利文, 等. 2014年中國40歲及以上人群慢性阻塞性肺疾病知識知曉率及其影響因素. 中華流行病學雜志, 2018, 39(5): 586-592.
7. Dai ZS, Ma YM, Zhan ZJ, et al. Analysis of diagnostic delay and its influencing factors in patients with chronic obstructive pulmonary disease: a cross-sectional study. Sci Rep, 2021, 11(1): 14213.
8. 周曉明, 吳岑, 趙立, 等. 我國北部地區部分三級醫院醫生對慢性阻塞性肺疾病認知現狀的橫斷面調查. 中華內科雜志, 2016, 55(9): 717-720.
9. 潘鋒. 三大國家項目助力我國慢阻肺防控. 中國醫藥導報, 2022, 19(5): 1-3.
10. Duan JX, Cheng W, Zeng YQ, et al. Characteristics of patients with chronic obstructive pulmonary disease exposed to different environmental risk factors: a large cross-sectional study. Int J Chron Obstruct Pulmon Dis, 2020, 15: 2857-2867.
11. Global Initiative for Chronic Obstructive Lung Disease Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease Global Initiative for Chronic Obstructive Lung Disease; 2018 [EB/OL] [Accessed: 2017 Oct 15]. Available from: http://www.goldcopd.org/.
12. Fang LW, Gao P, Bao HL, et al. Chronic obstructive pulmonary disease in China: a nationwide prevalence study. Lancet Respir Med, 2018, 6(6): 421-430.
13. Han MZ, Hsiue TR, Tsai SH, et al. Validation of the GOLD 2017 and new 16 subgroups (1A-4D) classifications in predicting exacerbation and mortality in COPD patients. Int J Chron Obstruct Pulmon Dis, 2018, 13: 3425-3433.
14. Hu YH, Liang ZY, Xu LM, et al. Comparison of the clinical characteristics and comprehensive assessments of the 2011 and 2017 GOLD classifications for patients with COPD in China. Int J Chron Obstruct Pulmon Dis, 2018, 13: 3011-3019.
15. Zha ZQ, Leng RX, Xu W, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in Anhui Province, China: a population-based survey. BMC Pulm Med, 2019, 19(1): 102.
16. Song Q, Chen P, Liu XM. The role of cigarette smoke-induced pulmonary vascular endothelial cell apoptosis in COPD. Respir Res, 2021, 22(1): 39.
17. 國務院關于實施健康中國行動的意見[EB/OL]. [2019-07-15]. http://www.gov.cn/zhengce/content/2019/07/15/contem-5409492.htm.
18. Pride NB. Smoking cessation: effects on symptoms, spirometry and future trends in COPD. Thorax, 2001, 56 Suppl 2(Suppl 2): ii7-ii10.
19. Whittaker H, Rubino A, Müllerová H, et al. Frequency and severity of exacerbations of COPD associated with future risk of exacerbations and mortality: a UK routine health care data study. Int J Chron Obstruct Pulmon Dis, 2022, 17: 427-437.
20. Song Q, Zhao YY, Zeng YQ, et al. The characteristics of airflow limitation and future exacerbations in different GOLD groups of COPD patients. Int J Chron Obstruct Pulmon Dis, 2021, 16: 1401-1412.
21. Martinez FJ, Lipworth BJ, Rabe KF, et al. Benefits of glycopyrrolate/formoterol fumarate metered dose inhaler (GFF MDI) in improving lung function and reducing exacerbations in patients with moderate-to-very severe COPD: a pooled analysis of the PINNACLE studies. Respir Res, 2020, 21(1): 128.
22. 王賡, 劉婷, 王發平, 等. 茚達特羅在慢性阻塞性肺疾病中的臨床應用. 中國呼吸與危重監護雜志, 2019, 18(3): 300-304.
23. 中華醫學會呼吸病學分會慢性阻塞性肺疾病學組, 中國醫師協會呼吸醫師分會慢性阻塞性肺疾病工作委員會. 慢性阻塞性肺疾病診治指南(2021年修訂版). 中華結核和呼吸雜志, 2021, 44(3): 170-205.
24. Crockett AJ, Moss JR, Cranston JM, et al. Domicilary oxygen for chronic obstructive pulmonary disease. Cochrane Database Syst Rev, 2000, (2): CD001744.
25. Aka Aktürk ü, G?rek Dilekta?l? A, ?engül A, et al. Influenza and pneumonia vaccination rates and factors affecting vaccination among patients with chronic obstructive pulmonary disease. Balkan Med J, 2017, 34(3): 206-211.
26. 樊靜, 叢舒, 王寧, 等. 2014-2015年中國40歲及以上慢性阻塞性肺疾病患者肺炎疫苗接種狀況. 中華流行病學雜志, 2020, 41(7): 1028-1033.
27. 劉聰, 彭雅婷, 李靜, 等. 慢性阻塞性肺疾病初診患者流感和肺炎疫苗接種狀況及影響因素: 真實世界橫斷面研究. 中華結核和呼吸雜志, 2022, 45(4): 355-361.

Chinese Journal of Respiratory and Critical Care Medicine

The clinical characteristics and treatment of patients with chronic obstructive pulmonary disease from year of 2018 to 2021

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