Peng Xianru, Huang Minyu, Zhao Wenqu, Yuan Yafei, Li Bohou, Ye Yanmei, Liang Jianpeng, Zhu Shunfang, Liu Laiyu, Cai Shaoxi, Zhao Haijin
Laboratory of Chronic Airway Diseases, Department of Respiratory and Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2018 Dec 30;38(12):1448-1452. doi: 10.12122/j.issn.1673-4254.2018.12.08.
To investigate the association of the time of initial diagnosis with the severity of chronic obstructive pulmonary disease (COPD).
A total of 803 patients who were diagnosed to have COPD for the first time in our hospital between May 2015 to February 2018 were enrolled in this study.The diagnoses of COPD and asthma COPD overlap (ACO) were made according GOLD guidelines and european consensus definition.Lung function of the patients was graded according to the GOLD guidelines.
The patients with COPD had a mean age of 61.8±9.9 years,including 726 male and 77 female patients.The course of the patients (defined as the time from symptom onset to the establishment of a diagnosis) was 3(0.5,8) years.Among these patients,85.2% had a moderate disease severity (FEV1%<80%),and 48.3% had severe or very severe conditions (FEV1%<50%);47.0% of them were positive for bronchial dilation test.In the overall patients,295(36.7%) were also diagnosed to have ACO,and the mean disease course of ACO[3(1,9) years]was similar to that of COPD3(0.5,8) years.A significant correlation was found between the disease course and the lung function of the patients.Multiple linear regression analysis showed that an older age and a longer disease course were associated with poorer lung functions and a greater disease severity.
The delay of the initial diagnosis is significantly related to the severity of COPD.
探讨慢性阻塞性肺疾病(COPD)初次诊断时间与疾病严重程度之间的关联。
选取2015年5月至2018年2月期间在我院首次诊断为COPD的803例患者纳入本研究。COPD和哮喘-COPD重叠综合征(ACO)的诊断依据全球慢性阻塞性肺疾病倡议(GOLD)指南和欧洲共识定义。患者的肺功能根据GOLD指南进行分级。
COPD患者的平均年龄为61.8±9.9岁,其中男性726例,女性77例。患者病程(定义为从症状出现到确诊的时间)为3(0.5,8)年。在这些患者中,85.2%的患者疾病严重程度为中度(FEV1%<80%),48.3%的患者为重度或极重度(FEV1%<50%);47.0%的患者支气管舒张试验呈阳性。在所有患者中,295例(36.7%)也被诊断为ACO,ACO的平均病程[3(1,9)年]与COPD[3(0.5,8)年]相似(P>0.05)。患者的病程与肺功能之间存在显著相关性。多元线性回归分析显示,年龄较大和病程较长与肺功能较差及疾病严重程度较高相关。
初次诊断延迟与COPD的严重程度显著相关。