% 0期刊文章% Lenferink,范德Palen Anke %, %工作van der Valk,保罗D.L.P.M. % Cafarella,保罗% van Veen安%奎因,斯蒂芬·% Groothuis-Oudshoorn, Catharina通用%伯特,莫顿g . %一个年轻的玛丽%弗里斯,彼得•A . %一个该死的挚友w . % T恶化行动计划对COPD患者和并发症:随机对照试验% D J 2019% R 10.1183/13993003.02134 -2018%欧洲呼吸杂志% P 1802134 % V 54% N 5% X这个国际随机对照试验评估是否慢性阻塞性肺病患者并发症,训练使用病人个体化multidisease恶化的行动计划,有更少的COPD恶化天比常规治疗(加州大学)。慢性阻塞性肺疾病全球计划II-IV类共病≥1例(缺血性心脏病、心力衰竭、糖尿病、焦虑、抑郁)的患者被随机分配到患者定制的自我管理干预(n=102)或UC (n=99)。每日症状日记完成12个月。主要结果“每位患者每年COPD加重天数”通过意向治疗分析进行评估。每年每位患者的COPD加重天数无显著差异(自我管理:中位数9.6(四分位区间(IQR) 0.7-31.1);UC:中位数15.6 (IQR 3.0-40.3);发病率比(IRR) 0.87 (95% CI 0.54;1.39);p = 0.546)。自我管理(自我管理:中位数8.1 (IQR 4.8-10.1)天; UC: median 9.5 (IQR 7.0–15.1) days; p=0.021), with no between-group differences in the total number of respiratory hospitalisations (IRR 0.76 (95% CI 0.42; 1.35); p=0.348), but a lower probability of ≥1 for respiratory-related hospitalisation compared to UC (relative risk 0.55 (95% CI 0.35; 0.87); p=0.008). No between-group differences were observed in all-cause hospitalisations (IRR 1.07 (95% CI 0.66; 1.72)) or mortality (self-management: n=4 (3.9%); UC: n=7 (7.1%); relative risk 0.55 (95% CI 0.17; 1.84)).Patient-tailored exacerbation action plans for COPD patients with comorbidities did not significantly reduce exacerbation days, but reduced the duration per COPD exacerbation and the risk of having at least one respiratory-related hospitalisation during follow-up, without excess all-cause mortality.Patient-tailored exacerbation action plans for COPD patients with comorbidities do not reduce exacerbation days, but reduce exacerbation duration and risk of having at least one respiratory-related hospitalisation during follow-up, without excess mortality http://bit.ly/2Mi8Fhc %U //www.qdcxjkg.com/content/erj/54/5/1802134.full.pdf