發(fā)布時間：2018-06-26 00:23

  本文選題：慢性阻塞性肺疾病 + 吸煙��； 參考：《中國實用內科雜志》2014年10期

【摘要】：目的觀察吸煙和生物燃料所致慢性阻塞性肺疾病(COPD)患者臨床特征的差異。方法回顧性分析2011年3月至2014年3月在廣州呼吸疾病研究所206例由吸煙和81例生物燃料導致的慢阻肺患者的臨床資料,分別比較了兩組患者的一般情況、臨床癥狀、呼吸困難評分和合并癥等方面的差異;肺功能和分級及急性加重的差異。結果 (1)一般情況的差異:吸煙所致慢阻肺患者中男性和女性的比例分別為83.5%和16.5%,生物燃料所致慢阻肺的患者中男性和女性的比例分別為14.8%和85.2%(χ2=27.2,P0.05)。吸煙所致慢阻肺患者多見于男性,而生物燃料所致慢阻肺患者多見于女性;性別矯正后,生物燃料所致的女性COPD患者的體重指數(shù)(BMI)低于吸煙所致的女性COPD患者的BMI。其他指標如年齡兩組差異無統(tǒng)計學意義。(2)臨床癥狀差異:生物燃料和吸煙所致慢阻肺患者的呼吸困難指數(shù)mMRC差異無統(tǒng)計學意義;生物燃料所致慢阻肺患者出現(xiàn)喘息癥狀多于吸煙所致慢阻肺的患者,分別為38.3%和11.1%(χ2=17.9,P0.05)。生物燃料所致慢阻肺患者合并過敏性疾病(如過敏性鼻炎、支氣管哮喘)比例高于吸煙所致慢阻肺的患者,分別為43.2%和18%(χ2=16.1,P0.05);而吸煙所致慢阻肺患者合并肺癌比例高于生物燃料所致慢阻肺的患者,分別為7.77%和3.7%(χ2=9.7,P0.05)。(3)肺功能分級的差異:慢阻肺分級上,性別校正后生物燃料所致慢阻肺患者分級更多見于B級或D級,癥狀多。(4)急性加重的差異:生物燃料所致和吸煙所致的慢阻肺患者1年內急性加重次數(shù)無顯著差異。結論吸煙和生物燃料所致的慢阻肺在臨床特征上有很多差異:生物燃料所致慢阻肺患者多見于女性,BMI低,臨床癥狀較多,合并癥以過敏性鼻炎和支氣管哮喘較多,慢阻肺分級多見于B級或D級。吸煙所致慢阻肺患者多見于男性,合并癥以肺癌較多。
[Abstract]:Objective to observe the clinical characteristics of chronic obstructive pulmonary disease (COPD) caused by smoking and biofuel. Methods the clinical data of 206 patients with COPD caused by smoking and 81 patients with chronic obstructive pulmonary disease caused by biofuel in Guangzhou Institute of Respiratory Diseases from March 2011 to March 2014 were analyzed retrospectively. Differences in dyspnea score and complications, pulmonary function and grade, and acute exacerbation. Results (1) the difference of general conditions: the proportion of male and female were 83.5% and 16.5%, respectively, and the proportion of male and female were 14.8% and 85.2% respectively (蠂 227.2P 0.05). After sex correction, the body mass index (BMI) of female COPD patients induced by biofuel was lower than that of female COPD patients induced by smoking. There was no significant difference in other indexes such as age. (2) the difference of clinical symptoms: there was no significant difference in mMRC between patients with chronic obstructive pulmonary disease caused by biofuel and smoking. The wheezing symptoms in patients with chronic obstructive pulmonary disease caused by biofuel were 38.3% and 11.1% respectively (蠂 2 / 17.9 P 0.05). The proportion of patients with chronic obstructive pulmonary disease caused by biofuel (such as allergic rhinitis, bronchial asthma) was higher than that of patients with chronic obstructive pulmonary disease caused by smoking. 43.2% and 18% (蠂 2 / 16.1%), respectively (蠂 2 / 16. 1%), but the proportion of lung cancer in patients with chronic obstructive pulmonary disease induced by smoking was higher than that in patients with chronic obstructive pulmonary disease caused by biofuel (7.77% and 3.7% respectively) (蠂 2 9.7U P 0.05). (3). After sex correction, the classification of patients with chronic obstructive pulmonary disease caused by biofuel was more frequently seen in grade B or D, with more symptoms. (4) acute exacerbation: there was no significant difference in acute exacerbation between biofuel induced COPD patients and smoking induced COPD patients within one year. Conclusion there are many differences in clinical characteristics between chronic obstructive pulmonary disease caused by smoking and biofuel. The patients with chronic obstructive pulmonary disease caused by biofuel are more common in women with low BMI, more clinical symptoms, and more allergic rhinitis and bronchial asthma. The grade of chronic obstructive pulmonary disease is often seen in grade B or D. Smoking-induced COPD is more common in men and lung cancer is more complicated.
【作者單位】： 呼吸疾病國家重點實驗室廣州醫(yī)科大學第一附屬醫(yī)院;廣東食品藥品職業(yè)學院;
【基金】：廣東省自然科學基金(s2013010016665)
【分類號】：R563.9

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