Gonzalez Lindh Margareta, Blom Johansson Monica, Jennische Margareta, Koyi Hirsh
Department of Neuroscience, Speech and Language Pathology, Uppsala University, Uppsala, Sweden; Centre for Research and Development (CFUG), Uppsala University, County Council of Gävleborg, Gävle, Sweden.
Department of Neuroscience, Speech and Language Pathology, Uppsala University, Uppsala, Sweden.
Int J Chron Obstruct Pulmon Dis. 2017 Jan 17;12:331-337. doi: 10.2147/COPD.S120207. eCollection 2017.
COPD is a common problem associated with morbidity and mortality. COPD may also affect the dynamics and coordination of functions such as swallowing. A misdirected swallow may, in turn, result in the bolus entering the airway. A growing body of evidence suggests that a subgroup of people with COPD is prone to oropharyngeal dysphagia. The aim of this study was to evaluate swallowing dysfunction in patients with stable COPD and to determine the relation between signs and symptoms of swallowing dysfunction and lung function (forced expiratory volume in 1 second percent predicted).
Fifty-one patients with COPD in a stable phase participated in a questionnaire survey, swallowing tests, and spirometry. A post-bronchodilator ratio of the forced expiratory volume in 1 second/best of forced vital capacity and vital capacity <0.7 was used to define COPD. Swallowing function was assessed by a questionnaire and two swallowing tests (water and cookie swallow tests).
Sixty-five percent of the patients reported subjective signs and symptoms of swallowing dysfunction in the questionnaire and 49% showed measurable ones in the swallowing tests. For the combined subjective and objective findings, 78% had a coexisting swallowing dysfunction. No significant difference was found between male and female patients.
Swallowing function is affected in COPD patients with moderate to severe airflow limitation, and the signs and symptoms of this swallowing dysfunction were subjective, objective, or both.
慢性阻塞性肺疾病（COPD）是一个与发病率和死亡率相关的常见问题。COPD 还可能影响诸如吞咽等功能的动态变化和协调性。误吸反过来可能导致食团进入气道。越来越多的证据表明，COPD 患者中的一个亚组易患口咽吞咽困难。本研究的目的是评估稳定期 COPD 患者的吞咽功能障碍，并确定吞咽功能障碍的体征和症状与肺功能（1 秒用力呼气容积占预计值百分比）之间的关系。
51 例稳定期 COPD 患者参与了问卷调查、吞咽测试和肺活量测定。使用支气管扩张剂后 1 秒用力呼气容积/用力肺活量最佳值和肺活量<0.7 的比值来定义 COPD。通过问卷调查和两项吞咽测试（饮水和吞饼干测试）评估吞咽功能。
65%的患者在问卷中报告了吞咽功能障碍的主观体征和症状，49%的患者在吞咽测试中表现出可测量的异常。综合主观和客观结果，78%的患者存在并存的吞咽功能障碍。男性和女性患者之间未发现显著差异。
中重度气流受限的 COPD 患者的吞咽功能受到影响，这种吞咽功能障碍的体征和症状有主观的、客观的或两者皆有。
