Barr R Graham, Celli Bartolome R, Mannino David M, Petty Thomas, Rennard Stephen I, Sciurba Frank C, Stoller James K, Thomashow Byron M, Turino Gerard M
Division of General Medicine, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Am J Med. 2009 Apr;122(4):348-55. doi: 10.1016/j.amjmed.2008.09.042.
Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States but is often undertreated. COPD often overlaps with other conditions such as hypertension and osteoporosis, which are less morbid but may be treated more aggressively. We evaluated the prevalence of these comorbid conditions and compared testing, patient knowledge, and management in a national sample of patients with COPD.
A survey was administered by telephone in 2006 to 1003 patients with COPD to evaluate the prevalence of comorbid conditions, diagnostic testing, knowledge, and management using standardized instruments. The completion rate was 87%.
Among 1003 patients with COPD, 61% reported moderate or severe dyspnea and 41% reported a prior hospitalization for COPD. The most prevalent comorbid diagnoses were hypertension (55%), hypercholesterolemia (52%), depression (37%), cataracts (31%), and osteoporosis (28%). Only 10% of respondents knew their forced expiratory volume in 1 second (95% confidence interval [CI], 8-12) compared with 79% who knew their blood pressure (95% CI, 76-83). Seventy-two percent (95% CI, 69-75) reported taking any medication for COPD, usually a short-acting bronchodilator, whereas 87% (95% CI, 84-90) of patients with COPD and hypertension were taking an antihypertensive medication and 72% (95% CI, 68-75) of patients with COPD and hypercholesterolemia were taking a statin.
Although most patients with COPD in this national sample were symptomatic and many had been hospitalized for COPD, COPD self-knowledge was low and COPD was undertreated compared with generally asymptomatic, less morbid conditions such as hypertension.
慢性阻塞性肺疾病（COPD）是美国第四大死因，但常常治疗不足。COPD常与其他疾病如高血压和骨质疏松症并存，这些疾病虽致死率较低，但治疗可能更为积极。我们评估了这些合并症的患病率，并比较了全国范围内COPD患者样本的检测情况、患者知识水平及治疗情况。
2006年通过电话对1003例COPD患者进行了一项调查，使用标准化工具评估合并症的患病率、诊断检测、知识水平及治疗情况。完成率为87%。
在1003例COPD患者中，61%报告有中度或重度呼吸困难，41%报告曾因COPD住院治疗。最常见的合并诊断为高血压（55%）、高胆固醇血症（52%）、抑郁症（37%）、白内障（31%）和骨质疏松症（28%）。只有10%的受访者知道自己的一秒用力呼气量（95%置信区间[CI]，8 - 12），相比之下，79%的人知道自己的血压（95% CI，76 - 83）。72%（95% CI，69 - 75）的人报告服用过治疗COPD的药物，通常是短效支气管扩张剂，而87%（95% CI，84 - 90）的COPD合并高血压患者服用了抗高血压药物，72%（95% CI，68 - 75）的COPD合并高胆固醇血症患者服用了他汀类药物。
尽管该全国样本中的大多数COPD患者有症状，且许多人曾因COPD住院，但与高血压等通常无症状、致死率较低的疾病相比，COPD患者的自我认知水平较低，且COPD治疗不足。
