Serviço de Pneumologia, Hospital das Clínicas, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia, GO, Brasil.
J Bras Pneumol. 2012 Nov-Dec;38(6):692-9. doi: 10.1590/s1806-37132012000600003.
To estimate the prevalence of undiagnosed COPD among individuals with risk factors for the disease treated at primary health care clinics (PHCCs) in the city of Aparecida de Goiânia, Brazil.
Inclusion criteria were being > 40 years of age, having a > 20 pack-year history of smoking or a > 80 hour-year history of exposure to biomass smoke, and seeking medical attention at one of the selected PHCCs. All subjects included in the study underwent spirometry for the diagnosis of COPD.
We successfully evaluated 200 individuals, mostly males. The mean age was 65.9 ± 10.5 years. The diagnosis of COPD was confirmed in 63 individuals, only 18 of whom had been previously diagnosed with COPD (underdiagnosis rate, 71.4%). There were no significant differences between the subgroups with and without a previous diagnosis of COPD in relation to demographics and risk factors. However, there were significant differences between these subgroups for the presence of expectoration, wheezing, and dyspnea (p = 0.047; p = 0.005; and p = 0.047, respectively). The FEV1 and FEV1/FVC ratio, expressed as percentages of the predicted values, were significantly lower in the subjects with a previous diagnosis of COPD, which was predominantly mild or moderate in both subgroups.
The rate of underdiagnosis of COPD was high at the PHCCs studied. One third of the patients with risk factors for COPD met the clinical and functional criteria for the disease. It seems that spirometry is underutilized at such facilities.
评估巴西阿帕雷西达戈亚尼亚市初级保健诊所（PHCC）治疗的患有 COPD 危险因素的个体中未确诊 COPD 的患病率。
纳入标准为年龄>40 岁，吸烟>20 包/年或暴露于生物量烟雾>80 小时/年，以及在选定的 PHCC 之一就诊。所有纳入研究的受试者均接受了肺量计检查以诊断 COPD。
我们成功评估了 200 名个体，主要为男性。平均年龄为 65.9±10.5 岁。63 名患者被确诊为 COPD，其中只有 18 名患者曾被诊断为 COPD（漏诊率为 71.4%）。在有无先前诊断为 COPD 的亚组之间，在人口统计学和危险因素方面无显著差异。然而，在有或无先前诊断为 COPD 的亚组之间，在咳痰、喘息和呼吸困难的存在方面存在显著差异（p=0.047;p=0.005;p=0.047，分别）。FEV1 和 FEV1/FVC 比值，以预测值的百分比表示，在有先前诊断为 COPD 的患者中明显较低，在两个亚组中均主要为轻度或中度。
在研究的 PHCC 中，COPD 的漏诊率较高。三分之一的 COPD 危险因素患者符合该疾病的临床和功能标准。似乎此类设施对肺量计的使用不足。
