Abstract：
BACKGROUND: Sensitization to Aspergillus fumigatus (AS) has been recently described in chronic obstructive pulmonary disease (COPD) patients. However, there is no data on the community prevalence of AS in COPD.
OBJECTIVE: To assess the prevalence of AS among COPD subjects. The secondary objectives were to (1) assess the prevalence of allergic bronchopulmonary aspergillosis (ABPA) in COPD and (2) compare the lung function in COPD subjects with and without AS.
METHODS: We conducted a cross-sectional study in rural (29 villages) and urban (20 wards) communities in North India. We identified individuals with respiratory symptoms (IRS) through a house-to-house survey using a modified IUATLD questionnaire. We then diagnosed COPD through specialist assessment and spirometry using the GOLD criteria. We assayed A.fumigatus-specific IgE in COPD subjects. In those with A. fumigatus-specific IgE ≥0.35 kUA/L (AS), ABPA was diagnosed with raised serum total IgE and raised A.fumigatus-specific IgG or blood eosinophil count.
RESULTS: We found 1315 (8.2%) IRS among 16,071 participants >40 years and diagnosed COPD in 355 (2.2%) subjects. 291 (82.0%) were men and 259 (73.0%) resided in rural areas. The prevalence of AS and ABPA was 17.7% (95% CI, 13.9-21.8) and 6.6% (95% CI, 4.4-8.8). We found a lower percentage predicted FEV1 in COPD subjects with AS than those without (p =.042).
CONCLUSIONS: We found an 18% community prevalence of AS in COPD subjects in a specific area in North India. Studies from different geographical areas are required to confirm our findings. The impact of AS and ABPA on COPD requires further research.
OBJECTIVE: To assess the prevalence of AS among COPD subjects. The secondary objectives were to (1) assess the prevalence of allergic bronchopulmonary aspergillosis (ABPA) in COPD and (2) compare the lung function in COPD subjects with and without AS.
METHODS: We conducted a cross-sectional study in rural (29 villages) and urban (20 wards) communities in North India. We identified individuals with respiratory symptoms (IRS) through a house-to-house survey using a modified IUATLD questionnaire. We then diagnosed COPD through specialist assessment and spirometry using the GOLD criteria. We assayed A.fumigatus-specific IgE in COPD subjects. In those with A. fumigatus-specific IgE ≥0.35 kUA/L (AS), ABPA was diagnosed with raised serum total IgE and raised A.fumigatus-specific IgG or blood eosinophil count.
RESULTS: We found 1315 (8.2%) IRS among 16,071 participants >40 years and diagnosed COPD in 355 (2.2%) subjects. 291 (82.0%) were men and 259 (73.0%) resided in rural areas. The prevalence of AS and ABPA was 17.7% (95% CI, 13.9-21.8) and 6.6% (95% CI, 4.4-8.8). We found a lower percentage predicted FEV1 in COPD subjects with AS than those without (p =.042).
CONCLUSIONS: We found an 18% community prevalence of AS in COPD subjects in a specific area in North India. Studies from different geographical areas are required to confirm our findings. The impact of AS and ABPA on COPD requires further research.
摘要：
背景：最近已在慢性阻塞性肺疾病（COPD）患者中描述了对烟曲霉（AS）的敏感性。然而,没有关于COPD患者AS社区患病率的数据.
目的：评估COPD受试者中AS的患病率。次要目标是（1）评估COPD中过敏性支气管肺曲霉病（ABPA）的患病率，以及（2）比较有和没有AS的COPD受试者的肺功能。
方法：我们在印度北部的农村（29个村庄）和城市（20个病房）社区进行了横断面研究。我们通过使用改良的IUATLD问卷的挨家挨户调查确定了有呼吸道症状（IRS）的个体。然后，我们使用GOLD标准通过专家评估和肺活量测定法诊断COPD。我们测定了COPD受试者中烟曲霉特异性IgE。在烟曲霉特异性IgE≥0.35kUA/L（AS）的患者中，ABPA被诊断为血清总IgE升高，烟曲霉特异性IgG或血液嗜酸性粒细胞计数升高。
结果：我们在16,071名参与者中发现1315（8.2％）IRS>40岁，在355（2.2％）受试者中诊断为COPD。291人（82.0％）是男性，259人（73.0％）居住在农村地区。AS和ABPA的患病率分别为17.7％（95％CI，13.9-21.8）和6.6％（95％CI，4.4-8.8）。我们发现患有AS的COPD受试者中预测的FEV1百分比低于没有AS的受试者（p=0.042）。
结论：我们发现在印度北部特定地区的COPD受试者中，社区AS患病率为18%。需要来自不同地理区域的研究来证实我们的发现。AS和ABPA对COPD的影响有待进一步研究。
目的：评估COPD受试者中AS的患病率。次要目标是（1）评估COPD中过敏性支气管肺曲霉病（ABPA）的患病率，以及（2）比较有和没有AS的COPD受试者的肺功能。
方法：我们在印度北部的农村（29个村庄）和城市（20个病房）社区进行了横断面研究。我们通过使用改良的IUATLD问卷的挨家挨户调查确定了有呼吸道症状（IRS）的个体。然后，我们使用GOLD标准通过专家评估和肺活量测定法诊断COPD。我们测定了COPD受试者中烟曲霉特异性IgE。在烟曲霉特异性IgE≥0.35kUA/L（AS）的患者中，ABPA被诊断为血清总IgE升高，烟曲霉特异性IgG或血液嗜酸性粒细胞计数升高。
结果：我们在16,071名参与者中发现1315（8.2％）IRS>40岁，在355（2.2％）受试者中诊断为COPD。291人（82.0％）是男性，259人（73.0％）居住在农村地区。AS和ABPA的患病率分别为17.7％（95％CI，13.9-21.8）和6.6％（95％CI，4.4-8.8）。我们发现患有AS的COPD受试者中预测的FEV1百分比低于没有AS的受试者（p=0.042）。
结论：我们发现在印度北部特定地区的COPD受试者中，社区AS患病率为18%。需要来自不同地理区域的研究来证实我们的发现。AS和ABPA对COPD的影响有待进一步研究。
