皇冠 網址
要津词：慢性袭击性肺疾病；从不抽烟者；系统综述；东谈主口特征
一、
本系统综述的先容
现时，慢性袭击性肺疾病(COPD)已成为巨匠第三大死因。在COPD的诱因中，天然抽烟是一个要津的环境危急身分，但当今仍是强劲到，宇宙上约30%的COPD病例发生在从不抽烟者 (NS) 中。可是，对于NS-COPD（从不抽烟者中的COPD）的流行病学、天然病史和临床特征尚不了了。事实上，当今险些莫得任因何意针对NS-COPD患者的规画。
现存信息来自于对大型抽烟干系COPD部队中NS-COPD患者亚组的分析。基于这些零碎的不雅察，总结以为NS-COPD多发于年青女性，呼吸系统症状较轻，呼吸主见一样，但爱惜谈梗阻较严重，肺气肿较少，肺功能随时期的下跌率较低，吞并症发生率较低。从生物学角度看，NS-COPD患者痰中中性粒细胞减少，嗜酸性粒细胞增多，巨噬细胞吞吃功能相配。
为进一步强劲NS-COPD，在这里，咱们对干系文件进行了系统讲究。
二、
检索战略、纳排神情和质料评估
皇冠体育
在PubMed (Medline) 和Embase数据库中进行文件检索，使用了以下解放文本的不同组合；MeSH术语和布尔运算符: chronic obstructive pulmonary disease; chronic airflowobstruction; chronic airflow limitation; AND non-smokers OR never-smokers。检索时期设定在2000年1月1日至2022年12月31日。
据了解，碳酸锂是锂行业中具有重要地位的锂盐产品，下游应用广泛。作为锂电产业核心原材料，碳酸锂主要运用于新能源汽车和储能等领域；同时，在工业领域，碳酸锂可作为陶瓷、玻璃、电解铝、制冷剂、光通讯、稀土电解的添加剂等；此外，碳酸锂还应用于医药等其他领域。
纳入神情: (a) 适合条目的规画策画包括部队规画、病例对照规画和横断面规画; (b) 规画东谈主群年事必须在18岁或以上，包括男性和女性，最小样本量为100名参与者，其中至少有20名患有COPD且从不抽烟; (c) 甩掉未提供从不抽烟者效力分类的规画; (d) COPD的会诊必须基于临床症状和支气管推广剂后FEV1/FVC <0.70的客不雅肺活量测定阐述。完成进一步筛查，剔除不适合要求的文件后最终获取17篇论文，扩充经由如图1所示。
采用以下神情进行评估:样本量;NS-COPD病例数;规画策画; COPD的会诊，每个名堂的得分从0到2，其中0为最低得分，8为总体最高得分 (如表1)。
图1 本规画纳入论文的选拔经由 (PubMed, Embase, 2000-2022)
皇冠博彩成功关键在于规划合理投注策略时刻保持清醒头脑。表1 对所纳入名堂进行的质料评定
COPD：慢性袭击性肺疾病；NS-COPD:从不抽烟者中的COPD；FEV1：第一秒使劲呼气容积；FVC：使劲肺活量；PBD：愚弄支气管推广剂后
三、
革命效力及分析
纳入的17项适合上述纳入/甩掉神情的规画中：规画的质料从2分（最小值）到6分（最大值），平均值为3.4分，标明举座质料为中-低质料。从患病率、严重进程、性别、年事、症状等方面进行策别离析，不错发现不同规画间存在的赫然异质性。
从症状上讲，NS-COPD患者多数进展为轻度至中度气流受限，对应于GOLD品级1级和2级；纳入规画中NS-COPD的性别干绑缚论异质性很强，有7项规画偏向于女性发病率大于男性，有5项规画以为男性发病率是女性的3倍以上；8项规画以为NS-COPD倾向于年事较大，中重度NS-COPD患病率跟着年事的增长而显贵增多，可是，在其他规画中，未不雅察到NS-COPD和S-COPD受试者之间存在赫然的年事干系各别；此外，一些规画一致以为，与S-COPD组比较，NS-COPD组呼吸谈症状(慢性咳嗽、咳痰、呼吸萧条和喘气)的患病率较低，比较之下三份规画阐扬了更多的症状 (使劲时呼吸萧条、慢性坐蓐性咳嗽和喘气)、更大的膂力当作放荡、更差的疾病适度、更低的氧弥散度和更高的就诊次数。
四、
结 语
hg0088皇冠这是第一个分析NS-COPD会诊过甚进展的临床特征的系统综述。本综述使用了成心为分内析策画的质料量表，可是，必须承认仍然存在一些潜在的放荡，NS-COPD患者的样本量不时较小，不时来自于较大的COPD患者部队的一部分，并莫得字据规画的质料成心策画的病例对照规画来细则抽烟者与不抽烟者的病因或特征，也缺乏旨在不雅察COPD抽烟者与不抽烟者在其他临床效力方面是否存在各别的随访规画。
笔者团队规画数据线路（中国全科医学，已接受，待发表），规画纳入NS-COPD患者中，女性42例，占80.8%（样本量较小，可扩大样本量后进一步规画），60岁以上NS-COPD患者47例，占89.4%，S-COPD与NS-COPD患者氧弥散度并莫得显贵各别（P=0.565）；国际规画中NS-COPD在不同性别散布规画效力各别较大，国际规画与笔者数据均线路NS-COPD中支气管炎型COPD多于肺气肿型COPD。
而当今咱们对于NS-COPD的学问严重缺乏，本系统综述中纳入的不同规画具有高度的异质性，进军需要策画普遍的规画来走访其临床特征和疾病天然史，况且鉴于好多发达国度抽烟率下跌的趋势，这少许尤其紧要。
皇冠客服飞机：@seo3687参考文件
1. Global Initiative for Chronic Obstructive Lung Disease (GOLD), in: Global Strategy for the Diagnosis, Management and Prevention of COPD; 2023 Report, GOLD: Fontana, WI, USA, 2023. Available online: https://goldcopd.org/2023-gold-report s-2/. (Accessed 8 January 2023).
2. D. Adeloye, S. Chua, C. Lee, et al., Global and regional estimates of COPD prevalence: systematic review and meta-analysis, J. Glob. Health. 5 (2) (2015 Dec), 020415, https://doi.org/10.7189/jogh.05.020415. PMID: 26755942; PMCID: PMC4693508.
3. G. Ntritsos, J. Franek, L. Belbasis, et al., Gender-specific estimates of COPD prevalence: a systematic review and meta-analysis, Int. J. Chronic Obstr. Pulm. Dis. 13 (2018 May 10) 1507–1514, https://doi.org/10.2147/COPD.S146390. PMID: 29785100; PMCID: PMC5953270.
4. M. Varmaghani, M. Dehghani, E. Heidari, F. Sharifi, S.S. Moghaddam, F. Farzadfar, Global prevalence of chronic obstructive pulmonary disease: systematic review and meta-analysis, East. Mediterr. Health J. 25 (1) (2019 Mar 19) 47–57, https://doi. org/10.26719/emhj.18.014.PMID:30919925.
www.royalbetonline.com5. I.A. Yang, C.R. Jenkins, S.S. Salvi, Chronic obstructive pulmonary disease in neversmokers: risk factors, pathogenesis, and implications for prevention and treatment, Lancet Respir. Med. 10 (5) (2022 May) 497–511, https://doi.org/10.1016/S2213- 2600(21)00506-3. Epub 2022 Apr 12. PMID: 35427530.
6. W.C. Tan, D.D. Sin, J. Bourbeau, et al., Characteristics of COPD in never-smokers and ever-smokers in the general population: results from the CanCOLD study, Thorax 70 (2015) 822–829.
7. A. Agustí, J.C. Hogg, Update on the pathogenesis of chronic obstructive pulmonary disease, N. Engl. J. Med. 381 (13) (2019 Sep 26) 1248–1256, https://doi.org/ 10.1056/NEJMra1900475. PMID: 31553836.
8. B. Lamprecht, M.A. McBurnie, W.M. Vollmer, et al., COPD in never smokers: results from the population-based burden of obstructive lung disease study, Chest 139 (4) (2011 Apr) 752–763, https://doi.org/10.1378/chest.10-1253. Epub 2010 Sep 30. PMID: 20884729; PMCID: PMC3168866.
9. G. Wang, A. Ma, L. Zhang, et al., Acute exacerbations of chronic obstructive pulmonary disease in a cohort of Chinese never smokers goes along with decreased risks of recurrent acute exacerbation, emphysema and comorbidity of lung cancer as well as decreased levels of circulating eosinophils and basophils, Front. Med. 9 (2022 Aug 10), 907893, https://doi.org/10.3389/fmed.2022.907893. PMID: 36035428; PMCID: PMC9400015.
10. J.Y. Choi, J.W. Kim, Y.H. Kim, et al., Clinical characteristics of non-smoking chronic obstructive pulmonary disease patients: findings from the KOCOSS cohort, COPD 19 (1) (2022) 174–181, https://doi.org/10.1080/15412555.2022.2053088. PMID:35392750.
11. S.S. Salvi, B.B. Brashier, J. Londhe, et al., Phenotypic comparison between smoking and non-smoking chronic obstructive pulmonary disease, Respir. Res. 21 (1) (2020 Feb 12) 50, https://doi.org/10.1186/s12931-020-1310-9. PMID: 32050955; PMCID: PMC7017521.
12. F. Güldaval, G. Polat, S. Doruk, et al., What are the differences between smoker and non-smoker COPD cases? Is it a different phenotype? Turk. Thorac. J. 22 (4) (2021 Jul) 284–288, https://doi.org/10.5152/TurkThoracJ.2021.20147. PMID: 35110244; PMCID: PMC8975314.
欧博三公13. A. Ramírez-Venegas, F. Montiel-Lopez, R. Falfan-Valencia, G. P´erez-Rubio, R. H. Sansores, The “slow horse racing effect” on lung function in adult life in chronic obstructive pulmonary disease associated to biomass exposure, Front. Med. 8 (2021 Jul 8), 700836, https://doi.org/10.3389/fmed.2021.700836. PMID: 34307427; PMCID: PMC8295605.
14. J. Bajpai, S. Kant, D.K. Bajaj, A. Pradhan, K. Srivastava, A.K. Pandey, Clinical, demographic and radiological profile of smoker COPD versus nonsmoker COPD patients at a tertiary care center in North India, J. Fam. Med. Prim. Care 8 (7) (2019 Jul) 2364–2368, https://doi.org/10.4103/jfmpc.jfmpc_347_19. PMID: 31463258; PMCID: PMC6691458.
15. J. Zhang, X. Lin, C. Bai, S. Bai, Comparison of clinical features between nonsmokers with COPD and smokers with COPD: a retrospective observational study, Int. J. Chronic Obstr. Pulm. Dis. 9 (1) (2014) 57–63, https://doi.org/10.2147/ COPD.S52416.
16. Sexton Paul, Peter Black, Lian Wu, et al., Chronic obstructive pulmonary disease in non-smokers: a case-comparison study, COPD, J. Chronic Obstr. Pulm. Dis. 11 (1) (2014) 2–9, https://doi.org/10.3109/15412555.2013.800853.
17. D.M. Shah, R.M. Kshatriya, R. Paliwal, Comparison of demographic, clinical, spirometry, and radiological parameters between smoking and non-smoking COPD patients in rural Gujarat, India, J. Fam. Med. Prim. Care 10 (2021) 3343–3347.
18. E. Fuller-Thomson, R.S. Chisholm, S. Brennenstuhl, COPD in a population-based sample of never-smokers: interactions among sex, gender, and race, Int. J. Chronic. Dis. 2016 (2016), 5862026, https://doi.org/10.1155/2016/5862026. Epub 2016 Dec 7. PMID: 28054032; PMCID: PMC5174166.
19. S.H. Lee, E.D. Hwang, J.E. Lim, et al., The risk factors and characteristics of COPD among nonsmokers in korea: an analysis of KNHANES IV and V, Lung 194 (3) (2016 Jun) 353–361, https://doi.org/10.1007/s00408-016-9871-6. Epub 2016 Apr 1. PMID: 27038474.
20. P.O. Bridevaux, N.M. Probst-Hensch, C. Schindler, et al., Prevalence of airflow obstruction in smokers and never-smokers in Switzerland, Eur. Respir. J. 36 (6) (2010) 1259–1269, https://doi.org/10.1183/09031936.00004110.
21. M. Thomsen, B.G. Nordestgaard, J. Vestbo, P. Lange, Characteristics and outcomes of chronic obstructive pulmonary disease in never smokers in Denmark: a prospective population study, Lancet Respir. Med. 1 (7) (2013 Sep) 543–550, https://doi.org/10.1016/S2213-2600(13)70137-1. Epub 2013 Jul 29. PMID: 24461615.
皇冠账号22. M.J. Page, J.E. McKenzie, P.M. Bossuyt, et al., The PRISMA 2020 statement: an updated guideline for reporting systematic reviews, BMJ (2021 Mar 29) 372, https://doi.org/10.1136/bmj.n71, n71.
皇冠体育比分网23. M. P´erez-Ríos, A. Schiaffino, M.J. Lopez, ´ et al., Questionnaire-based second-hand smoke assessment in adults, Eur. J. Publ. Health 23 (5) (2013 Oct) 763–767, https://doi.org/10.1093/eurpub/cks069. Epub 2012 Jun 8. PMID: 22683770.
24. M. Torres-Dur´ an, J.M. Barros-Dios, A. Fern´ andez-Villar, A. Ruano-Ravina, Residential radon and lung cancer in never smokers. A systematic review, Cancer Lett. 345 (1) (2014 Apr 1) 21–26, https://doi.org/10.1016/j.canlet.2013.12.010. Epub 2013 Dec 11. PMID: 24333737.
25. Rodríguez-Martínez A, ´ M. Torres-Duran, ´ J.M. Barros-Dios, A. Ruano-Ravina, Residential radon and small cell lung cancer. A systematic review, Cancer Lett. 426 (2018 Jul 10) 57–62, https://doi.org/10.1016/j.canlet.2018.04.003. Epub 2018 Apr 11. PMID: 2965489.
26. S. Hagstad, L. Ekerljung, A. Lindberg, H. Backman, E. Ronmark, ¨ B. Lundback, ¨ COPD among non-smokers - report from the obstructive lung disease in Northern Sweden (OLIN) studies, Respir. Med. 106 (7) (2012 Jul) 980–988, https://doi.org/ 10.1016/j.rmed.2012.03.010. Epub 2012 Apr 11. PMID: 22498109.
27. M. Denguezli, H. Daldoul, I. Harrabi, et al., COPD in nonsmokers: reports from the Tunisian population-based burden of obstructive lung disease study, PLoS One 11 (3) (2016 Mar 24), e0151981, https://doi.org/10.1371/journal.pone.0151981. PMID: 27010214; PMCID: PMC4807055.
28. T. Soumagne, A. Guillien, N. Roche, J.C. Dalphin, B. Degano, Never-smokers with occupational COPD have better exercise capacities and ventilatory efficiency than matched smokers with COPD, 2020 Dec 1, J. Appl. Physiol. 129 (6) (1985) 1257–1266, https://doi.org/10.1152/japplphysiol.00306.2020. Epub 2020 Oct 1. PMID: 33002379.
29. S. Hagstad, H. Backman, A. Bjerg, et al., Prevalence and risk factors of COPD among never-smokers in two areas of Sweden - occupational exposure to gas, dust or fumes is an important risk factor, Respir. Med. 109 (11) (2015 Nov) 1439–1445, https://doi.org/10.1016/j.rmed.2015.09.012. Epub 2015 Sep 26. PMID: 26440676.
澳门博彩在线网站30. M. Miravitlles, M. Ferrer, A. Pont, J. Luis Viejo, et al., Characteristics of a population of COPD patients identified from a population-based study. Focus on previous diagnosis and never smokers, Respir. Med. 99 (8) (2005 Aug) 985–995, https://doi.org/10.1016/j.rmed.2005.01.012. Epub 2005 Mar 4. PMID: 15950139.
31. B. Lamprecht, L. Schirnhofer, B. Kaiser, S. Buist, M. Studnicka, Non-reversible airway obstruction in never smokers: results from the Austrian BOLD study, Respir. Med. 102 (12) (2008 Dec) 1833–1838, https://doi.org/10.1016/j. rmed.2008.07.007. Epub 2008 Aug 22. PMID: 18722100.
皇冠体育赔率32. B. Cushen, I. Sulaiman, N. Donoghue, et al., High prevalence of obstructive lung disease in non-smoking farmers: the Irish farmers lung health study, Respir. Med. 115 (2016 Jun) 13–19, https://doi.org/10.1016/j.rmed.2016.04.006. Epub 2016 Apr 20. PMID: 27215498.
33. Y. Zhou, C. Wang, W. Yao, et al., COPD in Chinese nonsmokers, Eur. Respir. J. 33 (3) (2009 Mar) 509–518, https://doi.org/10.1183/09031936.00084408.PMID: 19251797.
34. H. Lee, Y. Hong, M.N. Lim, et al., Inflammatory biomarkers and radiologic measurements in never-smokers with COPD: a cross-sectional study from the CODA cohort, Chron. Respir. Dis. 15 (2) (2018 May) 138–145, https://doi.org/10.1177/ 1479972317736293.Epub2017Nov8. PMID: 29117798; PMCID: PMC5958470.
35. J. Montserrat-Capdevila, P. Godoy, J.R. Marsal, et al., Prevalencia y características de la enfermedad pulmonar obstructiva cronica ´ en no fumadores [Prevalence and characteristics of chronic obstructive pulmonary disease in non-smokers], Spanish, Atencion ´ Primaria 51 (10) (2019 Dec) 602–609, https://doi.org/10.1016/j. aprim.2017.10.012. Epub 2018 Nov 16. PMID: 30454958; PMCID: PMC6930941.
36. N. Nguyen Viet, F. Yunus, A. Nguyen Thi Phuong, et al., The prevalence and patient characteristics of chronic obstructive pulmonary disease in non-smokers in Vietnam and Indonesia: an observational survey, Respirology 20 (4) (2015 May) 602–611, https://doi.org/10.1111/resp.12507. Epub 2015 Mar 17. PMID: 25781616.
37. P.G. Camp, A. Ramirez-Venegas, R.H. Sansores, et al., COPD phenotypes in biomass smoke- versus tobacco smoke-exposed Mexican women, Eur. Respir. J. 43 (3) (2014 Mar) 725–734, https://doi.org/10.1183/09031936.00206112. Epub 2013 Oct 10. PMID: 24114962.
38. R. Perez-Padilla, R. Fernandez, M.V. Lopez Varela, et al., Airflow obstruction in never smokers in five Latin American cities: the PLATINO study, Arch. Med. Res. 43 (2) (2012 Feb) 159–165, https://doi.org/10.1016/j.arcmed.2012.03.007. Epub 2012 Apr 2. PMID: 22475778.
39. O.B. Ojuawo, A.O. Aladesanmi, C.M. Opeyemi, et al., Profile of patients with chronic obstructive pulmonary disease in Ilorin who were never-smokers, Niger. J. Clin. Pract. 22 (2) (2019 Feb) 221–226, https://doi.org/10.4103/njcp.njcp_344_ 18.PMID:30729946.
40. A. Agustí, G. Noell, J. Brugada, R. Faner, Lung function in early adulthood and health in later life: a transgenerational cohort analysis, Lancet Respir. Med. 5 (2017) 935–945.
41. S. Stanojevic, D.A. Kaminsky, M.R. Miller, et al., ERS/ATS technical standard on interpretive strategies for routine lung function tests, Eur. Respir. J. 60 (1) (2022 Jul 13), 2101499, https://doi.org/10.1183/13993003.01499-2021.PMID: 34949706.
42. Salvi SS, Brashier BB, Londhe J, et al. Phenotypic comparison between smoking and non-smoking chronic obstructive pulmonary disease. Respir Res. 2020;21(1):50. Published 2020 Feb 12. doi:10.1186/s12931-020-1310-9
43. Cornelius ME, Wang TW, Jamal A, Loretan CG, Neff LJ. Tobacco Product Use Among Adults - United States, 2019. MMWR Morb Mortal Wkly Rep. 2020;69(46):1736-1742. Published 2020 Nov 20. doi:10.15585/mmwr.mm6946a4
44. World Health Organization. Regional Office for Europe. (2019). European tobacco use: trends report 2019. World Health Organization. Regional Office for Europe. https://apps.who.int//iris/handle/10665/346817
本 期 作 者
孟爱宏 主任医生
医学博士/主任医生/训诫/博士生导师
河北医科大学第二病院北院区呼吸与危重症医学科主任
张智伟 硕士规画生
河北医科大学第二病院
本文仅代表作家个东谈主不雅点
仅供医务东谈主员参考
接待投稿至：conwhite_8@hotmail.com 皇冠 網址