Objective To explore the association of circadian rhythm to acute exacerbation of chronic ob-structive pulmonary disease. Methods 154 patients with COPD were selected and followed up for 3 years. The gen-eral condition of patients and the times of exacerbation were recorded. The association of smoking, age and gender to circadian rhythm exacerbation was analyzed. Results There were a total of 1401 times of acute exacerbation in 154 COPD patients, including 512 times (36. 5%) occurred from 6 am to 10 pm, and 889 times (63. 5%) from 10 pm to 6 am in the next morning. 82 cases belonged to sleep-type exacerbation of COPD, 32 cases to awake-type, and 40 cases to diffusing-type. The incidence of circadian rhythm exacerbation was obviously higher in elderly patients (≥70 years old) , smokers and male patients than in relatively young patients ( <70 years old) , non-smokers and female patients (P<0. 05). Conclusion The exacerbation shows circadian rhythm in patients with COPD, which is more likely to occur at night, especially in those smokers, elderly and male patients.%目的：探讨慢性阻塞性肺疾病(简称慢阻肺)患者病情加重与昼夜节律的相关性。方法对154例慢阻肺患者随访3年,记录每位患者的一般情况和病情加重的情况,分析吸烟、年龄、性别与慢阻肺病情加重昼夜节律的相关性。结果154例患者共出现急性加重次数1401次,觉醒型512次(36．5%),睡眠型889次(63．5%)。其中82例为睡眠型慢阻肺急性加重患者(53．2%),32例为觉醒型慢阻肺急性加重患者(20．8%),40例为弥散型慢阻肺急性加重(26．0%)。高龄(≥70岁)、吸烟和男性均较低龄(<70岁)、非吸烟和女性患者更容易出现夜间病情加重(P<0．05)。结论慢阻肺患者病情加重存在昼夜节律性,病情恶化更容易出现在夜间,睡眠型加重患者更为多见,尤其是吸烟、高龄男性。
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