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目的 了解上海市各临床分级慢性阻塞性肺疾病 (COPD)患者的一般情况、临床表现及诊断、治疗状况。方法 社区体检中经肺功能测定诊断为COPD的 198例患者 ,通过问卷调查获得其生活习惯、呼吸道症状、既往呼吸道疾病的诊断及治疗等信息。结果 198例中 ,男性占 6 8.2 % ,女性占 31.8% ;4 0～ 6 0岁占2 4 .8% ,6 0岁以上占 75 .2 %。曾经或现在吸烟者占 5 6 .6 % ,因父母或配偶吸烟而被动吸烟者分别占 6 7.2 %和6 2 .1%。Ⅰ、Ⅱ、Ⅲ、Ⅳ级COPD分别占 19.2 %、5 1.5 %、2 7.8%和 1.5 % ;Ⅰ和Ⅱ级COPD咳嗽、咳痰者分别为17.9%和 17.9% ;Ⅲ和Ⅳ级COPD呼吸困难、咳嗽、咳痰者分别为 74 .1%、5 6 .9%和 4 6 .6 %。 2 .5 %先前诊断为COPD ,11.1%曾接受肺功能测定 ,1.5 %使用过支气管扩张剂。结论 上海地区COPD的医院诊断率低 ,与疾病早期症状易被忽视、患者未及时就诊、门诊医师缺乏认识及未广泛开展肺功能测定有关。
Objective To understand the general situation, clinical manifestations, diagnosis and treatment of patients with chronic obstructive pulmonary disease (COPD) in Shanghai. Methods A total of 198 patients with COPD diagnosed by pulmonary function test in community physical examination were asked to get information about their lifestyle, respiratory symptoms and the diagnosis and treatment of previous respiratory diseases by questionnaire. Results Of the 198 cases, 6 8.2% were male, 31.8% were female, 40.4% were 40-60 years old, and 75.2% were over 60 years old. 56.6% of former or current smokers and 62.2% and 62.1% of passive smokers, respectively, were smokers because of their parents or spouse smoking. Grade I, II, III, and IV COPD accounted for 19.2%, 51.5%, 28.8% and 1.5% respectively; Grade I and II COPD cough and expectorant were 17.9% and 17.9% respectively; Grade III and IV COPD had dyspnea , Cough and expectorant were 74.1%, 56.9% and 46.6% respectively. 2.5% previously diagnosed as COPD, 11.1% had pulmonary function tests, and 1.5% had bronchodilators. Conclusions The hospital diagnosis rate of COPD in Shanghai is low, which is easily related to the early symptoms of the disease, the lack of timely medical treatment, the out-patient clinicians’ lack of awareness and the lack of extensive pulmonary function tests.