Würtemberger G, Schumacher H
AOK-Nordseeklinik, Norddorf/Amrum, Germany.
Pneumologie. 2002 May;56(5):288-92. doi: 10.1055/s-2002-30700.
Medical management of COPD begins with an awareness of risk factors and identification of risk patients. To identify this patients, 179 healthy volunteers with no known obstructive airway disease (81 women, 98 men, 40,5 +/- 11,2 years) and three different occupations (43 factory workers, 33 community workers, mainly working outside and 113 office employees) participated in the cross sectional spirometry study. Demographic data concerning age, height and body weight were comparable. In the first two groups were more men and more smokers. After adjustment to sex, age and height smokers revealed significant lower data for FEV 1 (3,16 l vs. 3,44 l) and FEV 1 /IVC (74,5 % vs. 77,6 %) in the factory workers. Comparable data exists for smokers in the community workers for FEV 1 (3,21 l vs. 3,59 l) and FEV 1 /IVC (74,8 % vs. 79,6 %), but not for office employees (FEV 1 3,51 l vs. 3,54 l; FEV 1 /IVC 76,1 % vs. 78,4 %). Airway obstruction, defined by FEV 1 /IVC below 70 % could be identified in thirteen of 57 smokers (22,8 %) and in twelve of 122 non-smokers (9,8 %) or in 25 of all 179 volunteers (14 %). The influence of smoking was significant (P = 0,0123). As a consequence, first there is a need for an increased awareness and routine spirometry in ad-risk patients; second, education and smoking cessation programs have to be initiated.
慢性阻塞性肺疾病（COPD）的医学管理始于对危险因素的认识和对高危患者的识别。为了识别这些患者，179名无已知阻塞性气道疾病的健康志愿者（81名女性，98名男性，40.5±11.2岁）以及三种不同职业（43名工厂工人、33名主要在户外工作的社区工作者和113名办公室职员）参与了横断面肺量计研究。有关年龄、身高和体重的人口统计学数据具有可比性。在前两组中男性更多且吸烟者更多。在对性别、年龄和身高进行调整后，工厂工人中的吸烟者在第1秒用力呼气容积（FEV1）（3.16升对3.44升）和FEV1/用力肺活量（FVC）（74.5%对77.6%）方面的数据显著更低。社区工作者中吸烟者的FEV1（3.21升对3.59升）和FEV1/FVC（74.8%对79.6%）也有类似数据，但办公室职员没有（FEV1 3.51升对3.54升；FEV1/FVC 76.1%对78.4%）。FEV1/FVC低于70%定义的气道阻塞在57名吸烟者中的13名（22.8%）以及122名非吸烟者中的12名（9.8%）中被识别出来，或者在所有179名志愿者中的25名（14%）中被识别出来。吸烟的影响具有显著性（P = 0.0123）。因此，首先有必要提高对高危患者的认识并进行常规肺量计检查；其次，必须启动教育和戒烟项目。
