本文選題：慢性阻塞性肺疾病 + 肺功能　； 參考：《吉林大學(xué)》2016年碩士論文

【摘要】：背景:慢性阻塞性肺疾病(Chronic obstructive pulmonary diseases,COPD)是“十三五”規(guī)劃全國重點(diǎn)防治的四大慢性疾病之一,肺功能進(jìn)行性下降是是其主要診斷及評價依據(jù)。全球COPD防治創(chuàng)議(Global initiative for chronic obstructive lung diseases,GOLD)指南強(qiáng)調(diào)任何考慮可能患有COPD的患者均應(yīng)進(jìn)行肺功能檢查。目的:通過對COPD患病率、診斷率、漏診率、吸煙對肺功能的影響、COPD存在合并癥時肺功能變化的研究,探討肺功能檢查在COPD患者早期診斷和臨床評價中的作用。方法:采用整群隨機(jī)抽樣調(diào)查方法,共調(diào)查年齡≥40周歲的長春市社區(qū)居民1393人,對所有調(diào)查對象進(jìn)行COPD調(diào)查問卷和肺功能檢查。問卷內(nèi)容包括調(diào)查對象的基本信息、COPD相關(guān)的高危因素、既往史等情況。肺功能檢查方法及質(zhì)控標(biāo)準(zhǔn)參照2014年肺功能檢查指南。結(jié)果:1.本次篩查共確診COPD患者176人,患病率為12.64%。漏診患者共160人,漏診率為90.91%。曾明確診斷為COPD共有16人,診斷率為9.09%。2.吸煙人群中COPD患病率為20.71%,明顯高于非吸煙人群的患病率8.8%(P0.05)。COPD吸煙組中吸煙指數(shù)與肺功能各指標(biāo)呈顯著負(fù)相關(guān),即隨著吸煙指數(shù)的增加,肺功能各指標(biāo)呈降低趨勢。3.與單純COPD組相比,COPD有合并癥組肺功能各項(xiàng)指標(biāo)均明顯偏低,而健康組和非COPD患病組兩組間肺功能指標(biāo)無明顯差異。4.與COPD有1種合并癥組相比,COPD有2種合并癥組肺功能各項(xiàng)指標(biāo)雖偏低,但無統(tǒng)計(jì)學(xué)差異(P0.05),而COPD有≥3種合并癥組肺功能指標(biāo)均明顯偏低,差異具有統(tǒng)計(jì)學(xué)意義。5.與單純COPD組相比,COPD合并哮喘組肺功能指標(biāo)除FVC%外,均明顯偏低,差異具有統(tǒng)計(jì)學(xué)意義。COPD合并CVD組肺功能指標(biāo)除PEF%、FEF75%外均明顯低于單純COPD組,差異具有統(tǒng)計(jì)學(xué)意義。COPD合并糖尿病組和單純COPD組兩組間肺功能未發(fā)現(xiàn)明顯差異。6.支氣管哮喘和心血管疾病(高血壓、冠心病)是COPD發(fā)病的危險因素。結(jié)論:1.長春地區(qū)40周歲以上社區(qū)居民COPD患病率及漏診率均較高,肺功能檢查在COPD早期診斷中起著至關(guān)重要的作用。2.吸煙人群中COPD患病率明顯高于非吸煙人群的患病率。COPD吸煙患者吸煙量越大,肺功能損害越重。3.與單純COPD患者相比,COPD患者存在合并癥時肺功能損害更為嚴(yán)重,并且隨著合并癥數(shù)目的增多,肺功能下降程度也會增加。4.支氣管哮喘和心血管疾病(高血壓、冠心病)是COPD發(fā)病的危險因素。
[Abstract]:Background: chronic obstructive pulmonary disease (CP) is one of the four major chronic diseases in the 13th Five-Year Plan. Progressive decline of pulmonary function is the main basis for its diagnosis and evaluation. The Global initiative for chronic obstructive lung Disease guidelines for Global initiative for chronic obstructive lung Disease (COPD) emphasize that any patient who considers possible COPD should undergo a pulmonary function test. Objective: to explore the role of pulmonary function examination in the early diagnosis and clinical evaluation of COPD patients by studying the effects of COPD prevalence, diagnostic rate, missed diagnosis rate and smoking on pulmonary function. Methods: a total of 1393 community residents aged more than 40 years were investigated by cluster random sampling. All the subjects were investigated by COPD questionnaire and pulmonary function test. The questionnaire included basic information about COPD related high-risk factors, past history and so on. Lung function test methods and quality control standards refer to the 2014 lung function test guidelines. The result is 1: 1. A total of 176 patients with COPD were diagnosed by this screening, and the prevalence rate was 12.64. There were 160 patients with missed diagnosis, and the missed diagnosis rate was 90.91%. A total of 16 patients were diagnosed with COPD, and the diagnostic rate was 9.09. 2. The prevalence rate of COPD in smoking population was 20.71, which was significantly higher than that in non-smoking population. The smoking index in 8.8%(P0.05).COPD smoking group was negatively correlated with the pulmonary function index, that is, with the increase of smoking index, the pulmonary function index showed a decreasing trend. Compared with the simple COPD group, the pulmonary function indexes were significantly lower in the patients with COPD, but there was no significant difference between the healthy group and the non-COPD group. 4. Compared with the group with one complication of COPD, the indexes of pulmonary function in the patients with COPD were lower, but there was no statistical difference between them (P 0.05), while the indexes of pulmonary function in the patients with COPD 鈮，

本文編號：1973884