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预防医学  2021, Vol. 33 Issue (11): 1091-1096    DOI: 10.19485/j.cnki.issn2096-5087.2021.11.003
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社区慢性阻塞性肺疾病患者肺功能分级与综合评估
陆凤, 陈向宇, 赵鸣, 张洁, 钟节鸣, 胡如英
浙江省疾病预防控制中心慢性非传染性疾病预防控制所,浙江 杭州 310051
Pulmonary function grading and comprehensive assessment in patients with chronic obstructive pulmonary disease
LU Feng, CHEN Xiangyu, ZHAO Ming, ZHANG Jie, ZHONG Jieming, HU Ruying
Department of Noncommunicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang 310051, China
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摘要 目的 分析社区慢性阻塞性肺疾病(COPD)患者肺功能分级和综合评估结果,为COPD社区综合管理提供依据。方法 收集2014—2015年≥40岁居民COPD国家监测项目浙江省5个监测点的资料,按照第一秒用力呼气容积(FEV1)占预计值的百分比进行肺功能分级,依据改良版英国医学研究委员会呼吸问卷(mMRC)、COPD自我评估测试(CAT)和过去1年急性加重情况进行综合评估分组。描述性分析COPD患者的不同肺功能分级和综合评估分组情况。结果 共纳入COPD患者355例,年龄为(63.00±9.63)岁,男女性别比为3.18:1。文化程度以小学及以下为主,243例占68.45%。COPD相关知识知晓率为1.69%。肺功能分级为轻度257例,占72.39%;中度86例,占24.23%;重度12例,占3.38%。轻度患者儿童期严重呼吸道感染史、自报呼吸系统疾病、慢性咳嗽、慢性咳痰、过去1年急性加重史、CAT评分≥10分和服用吸入药物的比例均低于中度和重度患者(P<0.05);体质指数和腰围平均值高于中度和重度患者(P<0.05)。综合评估A组158例,占44.51%;B组134例,占37.75%;C组1例,占0.28%;D组7例,占1.97%。A组患者平均年龄和收缩压低于B、C、D组患者,自报呼吸系统疾病、呼吸系统疾病家族史、慢性咳痰、呼吸困难、过去1年急性加重史和CAT评分≥10分的比例低于B、C、D组患者(均P<0.05)。结论 社区COPD患者肺功能分级以轻度为主,综合评估以A组为主,建议社区对COPD患者实施分级管理。
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陆凤
陈向宇
赵鸣
张洁
钟节鸣
胡如英
关键词 慢性阻塞性肺疾病肺功能分级综合评估社区    
AbstractObjective To understand the characteristics of different pulmonary function grades and comprehensive assessment groups among patients with chronic obstructive pulmonary disease (COPD) from community survey, so as to provide the evidence for the comprehensive community management of COPD. Methods The survey data of five monitoring sites in Zhejiang Province during 2014-2015 in the COPD surveillance of Chinese residents aged 40 years and above was collected. The patients with COPD were classified by pulmonary function according to the percentage of forced expiratory volume in the first second (FEV1) in the predicted value, and by comprehensive assessment according to modified British Medical Research Council (mMRC) score, COPD Assessment Test (CAT) score and acute exacerbation in the past year. The characteristics of different pulmonary function grading and comprehensive assessment groups were compared. Results A total of 355 patients with COPD were found, with an average age of (63.00±9.63) years. The male-to-female ratio was 3.18:1. There were 243 patients with an education level of primary school or below, accounting for 68.45%. The awareness rate of COPD related knowledge was only 1.69%. There were 257 (72.39%) patients with mild, 86 (24.23%) patients with moderate, and 12 (3.38%) patients with severe pulmonary function. The proportions of patients with childhood history of severe respiratory infection, self-reported respiratory system diseases, chronic cough, chronic sputum, acute exacerbation in the past year, CAT score ≥10 points, and inhaled medication were lower in the patients with mild pulmonary function than with moderate and severe pulmonary function; the body mass index and waist circumference were higher in the patients with mild pulmonary function than in the patients with moderate and severe pulmonary function (all P<0.05). The comprehensive assessment resulted in 158 (44.51%) patients of Group A, 134 (37.75%) patients of Group B, 1 (0.28%) patient of Group C, and 7 (1.97%) patients of Group D. The average age and systolic pressure were lower in Group A than in Group B, C and D; the proportions of patients with self-reported respiratory system diseases, family history of respiratory diseases, chronic cough, chronic sputum, dyspnea, acute exacerbation in the past year and CAT score ≥10 points were lower in Group A than in Group B, C and D (all P<0.05). Conclusion The community patients with COPD are mainly classified to mild pulmonary function and Group A in the comprehensive assessment; thus they need different levels of management.
Key wordschronic obstructive pulmonary disease    pulmonary function grading    comprehensive assessment    community
收稿日期: 2021-04-12      修回日期: 2021-08-16      出版日期: 2021-11-10
中图分类号:  R563.9  
基金资助:浙江省医药卫生科技计划项目(2020KY518)
通信作者: 胡如英,E-mail:ryhu@cdc.zj.cn   
作者简介: 陆凤,硕士,主管医师,主要从事慢性病预防控制工作
引用本文:   
陆凤, 陈向宇, 赵鸣, 张洁, 钟节鸣, 胡如英. 社区慢性阻塞性肺疾病患者肺功能分级与综合评估[J]. 预防医学, 2021, 33(11): 1091-1096.
LU Feng, CHEN Xiangyu, ZHAO Ming, ZHANG Jie, ZHONG Jieming, HU Ruying. Pulmonary function grading and comprehensive assessment in patients with chronic obstructive pulmonary disease. Preventive Medicine, 2021, 33(11): 1091-1096.
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http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2021.11.003      或      http://www.zjyfyxzz.com/CN/Y2021/V33/I11/1091
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