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Objective:To observe the clinical characteristics and guideline compliance of chronic obstructive pulmonary disease (COPD) patients with initial triple therapy in real-life world.Methods:This study is a cross-sectional study. The subjects of the study were COPD patients admitted to 13 hospitals in Hunan Province and Guangxi Zhuang Autonomous Region from December 2016 to December 2021. The initial treatment was triple inhaled drugs. The data collected included gender, age, diagnosis, body mass index (BMI), history of acute exacerbation (AE) in the past year, pulmonary function, COPD Assessment Test (CAT) score, modified British Medical Research Council Dyspnea Questionnaire (mMRC), inhaled drugs and other indicators. The characteristics and differences of COPD patients before and after 2020 were analyzed.Results:7 184 patients with COPD were enrolled in this study, including 2 409 COPD patients treated with initial triple therapy, accounting for 33.5%(2 409/7 184). Taking January 1st, 2020 as the cut-off point, 1 825 COPD patients (75.8%) received initial treatment with triple inhaled drugs before 2020 and 584 patients (24.2%) after 2020 were included in this study. Compared with COPD patients before 2020, the COPD patients after 2020 had higher FEV 1% [(40.9±15.5 )% vs (39.3±15.5)%, P=0.040], lower CAT [(15.8±6.5)point vs (17.5±6.2)point, P<0.001], less AE in the past year [1(0, 2)times vs 1(0, 2)times, P=0.001] and higher rate of non-AE [255(43.7%) vs 581(37.1%), P=0.006]. In addition, before 2020, patients with COPD were mainly treated with open triple drugs (1 825/1 825, 100%); after 2020, 306 patients (52.4%) received open triple inhaled drugs, and 278 patients (47.6%) received closed triple inhaled drugs. Conclusions:In real-life world, most of patients with COPD treated with triple therapy have severe lung function, obvious symptoms and high risk of acute exacerbation. The real-world prescribing of triple therapy in patients with COPD does not always reflect recommendations in guidelines and strategies, and overtreatment is common. After 2020, prescribing triple therapy for COPD patients is more positive and worse consistency with guideline.
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Objective To investigate the genetic predisposing factor of chronic obstructive pulmonary disease (COPD) by studying the distribution of vitamin D receptor (VDR) gene polymorphisms in patients with COPD in Changsha.Methods Totally 120 COPD patients and 120 volunteers were enrolled in the study.Polymorphisms of VDR genes including Apa I and Bsm I were detected with polymerase chain reaction-restriction fragments length polymorphism (RFLP).Results There existed statistical difference in polymorphism of Apa I gene and frequency of distribution on its allele between two groups (P ＜ 0.05),while there is no significant difference on Bsm I gene between the two groups (P ＞ 0.05).Conclusions COPD is associated with the polymorphism of VDR-Apa I.There may be no relationship on VDR-Bsm I between two groups.
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OBJECTIVE@#To survey the prevalence of vitamin D deficiency in patients with chronic obstructive pulmonary disease (COPD) and to determine the impact of vitamin D deficiency on the quality of life in COPD patients.@*METHODS@#Thirty-six patients with acute exacerbations of COPD (AECOPD group), 38 outpatients with stable COPD (stable COPD group), and 30 healthy subjects (control group) in the Third Hospital of Changsha were enrolled in our study from Dec. 2011 to Mar. 2012. The serum levels of 25-(OH)D were measured in all subjects by ELISA. The prevalence of vitamin D deficiency was calculated and compared among the 3 groups. Scores of COPD assessment test (CAT) were measured and compared in the AECOPD group and the stable COPD group and the relation between 25-(OH)D and CAT scores was analyzed.@*RESULTS@#1) The levels of 25-(OH)D in the AECOPD group and the stable COPD group were significantly lower than those in the control group. The level of 25-(OH)D in the AECOPD group was significantly lower than that in the stable COPD group (P0.05). 4) significant difference was found between the AECOPD group and the stable COPD group in CAT scores (P<0.01). 5) Both in the AECOPD group and the stable COPD group, the 25-(OH)D levels were negatively correlated with CAT scores (r=-0.603, P<0.01; r=-0.549, P<0.01, respectively).@*CONCLUSION@#Vitamin D deficiency is highly prevalent in COPD patients. Vitamin D deficiency may have negative impact on the life quality in COPD patients.