American Journal of Respiratory and Critical Care Medicine. 2022 Nov 21; PMID: 36409973Plasticity of Individual Lung Function States from Childhood to Adulthood.Gang Wang, Jenny Hallberg, Rosa Faner, et al这项研究验证了肺功能发育受损将使成年后罹患呼吸疾病的风险上升。那么,怎么能让肺功能不要输在起跑线上?这项研究的价值在于用事实证明了危险因素暴露将损害肺发育,而“先天不足”也有机会“后天”补上。危险因素个数越多,起跑线上落后或者“长僵掉”的可能性越大。而起跑线上即便处于落后状态,通过规避危险因素暴露,仍能随着生长发育赶上同龄人。
划重点:这项研究分析的危险因素包括母亲在怀孕期间吸烟、父母在孩子0-1岁期间吸烟、婴幼儿儿童期支气管炎、早产、婴儿期呼吸道合胞病毒感染/肺炎、4-8岁时对食物过敏和0-8岁时的儿童哮喘。
Thorax. 2022 Nov 24; PMID: 36423926Mortality in non-exacerbating COPD: a longitudinal analysis of UK primary care data.Alexandra Lenoir, Hannah Whittaker, Alicia Gayle, et alThorax. 2022 Dec 1; PMID: 36456179Airflow limitation and mortality during cancer screening in the National Lung Screening Trial: why quantifying airflow limitation matters.Robert P Young, Ralph C Ward, Raewyn J Scott, et al原文讨论了该项研究的意义,意思是重度气流受限者做CT筛查肺癌价值不大,相对于胸片筛查因肺癌死亡下降不明显么,拍片子就可以了。这种反直觉的现象是怎么产生的呢?研究中作了分析:是因为对于重度气流受限者,手术因肺功能较差而受限(肺癌筛查的获益主要来源于早期发现争取根治机会),以及这些患者往往还没等到死于肺癌就已殁于其他疾病了。因此,期望在GOLD 3-4级患者中提高CT筛查肺癌的价值,需要开发射频消融等新技术,同时加强包括慢阻肺在内的合并症的管理。 Chest. 2022 Nov 26; PMID: 36442662Comparison of Clinical Outcomes among Different Fixed-dose Combinations of Long-acting Muscarinic Antagonists and Long-acting β 2 -agonists (LAMA/LABA) in Patients with Chronic Obstructive Pulmonary Disease.Ching-Fu Weng, Chien-Chih Wu, Mei-Hsuan Wu, et al该项真实世界研究显示:接受UMEC/VI或GLY/IND的COPD患者发生重度AE的风险低于接受TIO/OLO的患者;而各组心血管事件的发生率相似,尽管与TIO/OLO组相比,GLY/IND组略低。American Journal of Respiratory and Critical Care Medicine. 2022 Dec 8; PMID: 36480957Long-Term Telerehabilitation or Unsupervised Training at Home for Patients with Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial.Paolo Zanaboni, Birthe Dinesen, Hanne Hoaas, et al