T1 -慢性阻塞性肺病患者和合并疾病患者的加重行动计划:随机对照试验JF -欧洲呼吸杂志》乔和J - 10.1183/13993003.02134 -2018欧元六世- 54 - 5 SP - 1802134 AU Lenferink Anke AU -范德Palen工作非盟-范德Valk保罗D.L.P.M.盟——Cafarella保罗AU - van Veen安非盟-奎因,斯蒂芬•AU - Groothuis-Oudshoorn Catharina通用非盟-伯特,莫顿g . AU -年轻,玛丽AU -弗里斯,彼得·a .盟——该死的,【摘要】N2 -本国际随机对照试验评估了患有共病的慢性阻塞性肺病患者，在使用患者定制的多种疾病加重行动计划方面进行培训后，其COPD加重天数是否少于常规护理(UC)。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)。 There was a significantly shorter duration per COPD exacerbation for self-management (self-management: median 8.1 (IQR 4.8–10.1) days; 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 ER -