Kömüs Nuray, Tertemiz Kemal Can, Sevinç Can
Nizip State Hospital, Gaziantep, Turkey.
Tuberk Toraks. 2008;56(4):382-9.
Chronic obstructive pulmonary disease (COPD) is an important world health problem and estimated that the prevalance will increase. In early period this disease in symptomatic with cough, sputum and dyspnea. FEV(1)/FVC was greater than 70% in early period and it was accepted as stage 0 (at risk) COPD before the last The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline. In last GOLD guideline this stage is excluded. In this study we aimed to find out the clinical differences between this cases and healty population. Prospectively spirometric measures, exercise capacity, dyspnea index, saturation of O2 (SpO2) and life quality are compared between two groups. We evaluated 58 at risk cases and 63 healty adults. There was no difference between two groups about age, sex and smoke cessations. In at risk group 77.6% cough, 53.4% sputum and 62.1% dyspnea were the symptoms. In currently smokers cough and sputum were dominant symptoms however dyspnea was dominant symptom in exsmokers. Absolute FEV1, FEF25-75 values, predicted FEV1/FVC, FEV1, FVC, PEF, FEF25-75% values are lower in at risk group (p<0.05). Mean six minutes walking distance were lower in at risk group but not statistically significant (p>0.05). Dyspnea index before walking were not different between two groups (p>0.05) however dyspnea index after walking and change were higher in at risk group (p>0.05). Resting SpO2, SpO2 after exercise and desaturation with exercise (DeltaSpO2) were lower in at risk group but not statistically significant. Physical and mental components of Short Form 36 (SF36) scores were similar in two groups (p>0.05). COPD at risk group is separated from healty population with chronic respiratory symptoms and inhalation of smoke or other irritans. In these cases spirometric measures are significantly worse although functional parametres are similar with healty population, so it is thought about being a subclinical disease. These cases must be educated about COPD, encouraged about giving up smoking and prevented occurring COPD.
慢性阻塞性肺疾病（COPD）是一个重要的全球健康问题，预计其患病率将会上升。在疾病早期，症状表现为咳嗽、咳痰和呼吸困难。在早期，第一秒用力呼气容积（FEV₁）/用力肺活量（FVC）大于70%，在上一版《慢性阻塞性肺疾病全球倡议》（GOLD）指南发布之前，这一阶段被认定为0期（高危）COPD。在最新的GOLD指南中，这一阶段已被排除。在本研究中，我们旨在找出这些病例与健康人群之间的临床差异。前瞻性地比较了两组的肺功能测量指标、运动能力、呼吸困难指数、氧饱和度（SpO₂）和生活质量。我们评估了58例高危病例和63名健康成年人。两组在年龄、性别和戒烟情况方面没有差异。在高危组中，77.6%的人有咳嗽症状，53.4%的人有咳痰症状，62.1%的人有呼吸困难症状。在当前吸烟者中，咳嗽和咳痰是主要症状，而在既往吸烟者中，呼吸困难是主要症状。高危组的FEV₁绝对值、FEF₂₅₋₇₅值、预计FEV₁/FVC、FEV₁、FVC、呼气峰值流速（PEF）、FEF₂₅₋₇₅%值均较低（p<0.05）。高危组的平均6分钟步行距离较低，但无统计学意义（p>0.05）。两组步行前的呼吸困难指数无差异（p>0.05），但高危组步行后的呼吸困难指数及变化更高（p>0.05）。高危组静息SpO₂、运动后SpO₂和运动时的氧饱和度下降（ΔSpO₂）较低，但无统计学意义。两组的简明健康状况调查量表（SF-36）的生理和心理成分得分相似（p>0.05）。COPD高危组因慢性呼吸道症状以及吸入烟雾或其他刺激物而与健康人群区分开来。在这些病例中，尽管功能参数与健康人群相似，但肺功能测量指标明显更差，因此被认为是一种亚临床疾病。必须对这些病例进行COPD相关教育，鼓励他们戒烟，并预防COPD的发生。
