Jia Guohua, Lu Ming, Wu Rui, Chen Yahong, Yao Wanzhen
Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China,
Int J Chron Obstruct Pulmon Dis. 2018 Oct 10;13:3269-3280. doi: 10.2147/COPD.S176173. eCollection 2018.
To investigate the gender difference in knowledge, attitude, and practice of COPD diagnosis and treatment in China.
A nationwide, multicenter, cross-sectional questionnaire study was carried out to investigate patients' understanding and experience of COPD between September 2007 and December 2008.
Two thousand and seventy-two patients were recruited from eleven centers. The final effective questionnaires were those of 1,698 cases, of which 32% were female. Women were younger, had higher body mass index, were more never smokers, and had lesser pack-years (all <0.01). More women had under elementary education level and monthly income <1,000 RMB (about 160 USD) (all <0.01). Women had higher ratio of FEV/FVC (54.1±10.9 vs 50.2±11.5), FEV% (50.0±19.1 vs 45.4±29.0), and lower short form-36 mental component summary (57.5±26.8 vs 61.3±25.0) (all <0.01). Fewer women reported severe exacerbation (defined as an acute worsening of respiratory symptoms that results in patient's hospitalization) in the previous year (44.5% vs 51.6%, <0.05). More women reported that they never heard of COPD before (67.0% vs 59.0%, <0.01). Less women reported that physician had to tell them they had emphysema (50.5% vs 60.4%) or COPD (31.9% vs 37.9%). Less women had pulmonary function test (PFT) done before (65.2% vs 70.4%, <0.05). More women reported that they would not repeat PFT annually (91.7% vs 87.6%, <0.05) and did not know the PFT results (78.6% vs 73.1%, <0.05). More women reported not having had pulmonary rehabilitation before (87.8% vs 83.6%, <0.05). Fewer women reported knowing that COPD should be given combined therapy (38.3% vs 44.5%) and long-term treatment (46.1% vs 51.9%) (all <0.05).
Male and female patients had different experiences on COPD diagnosis and treatment. Physicians should pay more attention to patients' education on COPD, especially of women.
调查中国慢性阻塞性肺疾病(COPD)诊断与治疗的知识、态度及实践方面的性别差异。
于2007年9月至2008年12月开展了一项全国性、多中心横断面问卷调查研究,以调查患者对COPD的了解及经历。
从11个中心招募了2072例患者。最终有效问卷为1698例,其中女性占32%。女性年龄更小,体重指数更高,从不吸烟者更多,吸烟包年数更少(均P<0.01)。更多女性受教育程度为小学及以下且月收入<1000元人民币(约160美元)(均P<0.01)。女性的第1秒用力呼气容积/用力肺活量(FEV/FVC)(54.1±10.9对50.2±11.5)、第1秒用力呼气容积占预计值百分比(FEV%)(50.0±19.1对45.4±29.0)更高,而36条目简明健康状况调查问卷精神健康分量表得分更低(57.5±26.8对61.3±25.0)(均P<0.01)。更少女性报告上一年有严重加重(定义为导致患者住院的呼吸道症状急性恶化)(44.5%对51.6%,P<0.05)。更多女性报告她们之前从未听说过COPD(67.0%对59.0%,P<0.01)。更少女性报告医生曾告知她们患有肺气肿(50.5%对60.4%)或COPD(31.9%对37.9%)。更少女性之前进行过肺功能检查(PFT)(65.2%对70.4%,P<0.05)。更多女性报告她们不会每年重复进行PFT(91.7%对87.6%,P<0.05)且不知道PFT结果(78.6%对73.1%,P<0.05)。更多女性报告之前未接受过肺康复治疗(87.8%对83.6%,P<0.05)。更少女性报告知道COPD应接受联合治疗(38.3%对44.5%)和长期治疗(46.1%对51.9%)(均P<0.05)。
男性和女性患者在COPD诊断与治疗方面有不同经历。医生应更加关注对患者,尤其是女性患者的COPD教育。