Li X, Dai W R, Li L, Liu W F, Yang Z X, Xie L
Hunan Occupational Disease Prevention and Treatment Hospital, Changsha 410007, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2019 Mar 20;37(3):207-210. doi: 10.3760/cma.j.issn.1001-9391.2019.03.010.
To investigate the compliance of inhalation during stable phase of pneumoconiosis complicated with COPD and to explore the factors influencing compliance. The patients with pneumoconiosis complicated with COPD who were hospitalized in the four Department of occupational disease prevention and treatment in Hunan province from December 2016 to August 2017 were selected as the research subjects. The examination of Chest radiograph, HRCT and lung function was perfected, and CAT score and MRC score were carried out. The age, culture, smoking history, acute aggravation of 1 years, medical insurance and so on were collected, and follow-up was conducted after 6 months. Of the 115 patients who had successfully followed up, 14 cases (12.17%) were persisted in medication, and 101 cases (87.83%) did not adhere to the medication. The smoking index median of the non adherence group was 30 (15, 40) , while that of the adherence group was 16 (6, 31) . The smoking index of the adherence group was lower than that of the non adherence group. The FEV1% in the unadhered group was 44.69+15.48, and the drug group was 37.12+16.98, the FEV(1)/FVC in the unadhered group was 52.43+9.19, and the drug group was 44.43+11.88, and the lung function of the drug group was worse than that of the unadhered group. The adherence rate of group COPD (group D) was higher than that of group A, B and C, and the difference between D group and B group was statistically significant. The adherence rate of pneumoconiosis stage Ⅲ was higher than that of pneumoconiosis stageⅡand pneumoconiosisⅠ. The compliance of long acting bronchodilator inhalation is low in stable phase of pneumoconiosis complicated with COPD. The poorer the lung function, the higher the compliance of inhalation. The compliance of pneumoconiosis patients with Medical insurance for industrial injury is higher than that of pneumoconiosis patients with New rural cooperative medical service.
调查尘肺病合并慢性阻塞性肺疾病（COPD）稳定期患者吸入治疗的依从性，并探讨影响依从性的因素。选取2016年12月至2017年8月在湖南省四个职业病防治科住院的尘肺病合并COPD患者作为研究对象。完善胸部X线片、高分辨率CT（HRCT）及肺功能检查，并进行慢阻肺评估测试（CAT）评分和医学研究委员会（MRC）评分。收集患者年龄、文化程度、吸烟史、1年内急性加重次数、医疗保险等情况，并于6个月后进行随访。在115例成功随访的患者中，14例（12.17%）坚持用药，101例（87.83%）未坚持用药。未坚持用药组的吸烟指数中位数为30（15，40），而坚持用药组为16（6，31）。坚持用药组的吸烟指数低于未坚持用药组。未坚持用药组的第1秒用力呼气容积占预计值百分比（FEV1%）为44.69±15.48，用药组为37.12±16.98；未坚持用药组的FEV1/用力肺活量（FVC）为52.43±9.19，用药组为44.43±11.88，用药组的肺功能比未坚持用药组差。慢性阻塞性肺疾病D组的依从率高于A、B、C组，D组与B组的差异有统计学意义。三期尘肺病的依从率高于二期和一期尘肺病。尘肺病合并COPD稳定期长效支气管扩张剂吸入治疗的依从性较低。肺功能越差，吸入治疗的依从性越高。有工伤保险的尘肺病患者的依从性高于参加新型农村合作医疗的尘肺病患者。
