Khosla T, Lowe C R
Br J Prev Soc Med. 1974 Aug;28(3):156-63. doi: 10.1136/jech.28.3.156.
Seven mutually exclusive groups of non-bronchitics and chronic bronchitics are derived from 10,816 steel workers questioned and examined at Port Talbot. These groups are based on various combinations of responses to the Medical Research Council questionnaire on cough, phlegm, dyspnoea, increased cough and phlegm, and chest illness. The groups are formed on defined criteria of (1) a reasonable number of men in each group; (2) impairment of lung function (FEV) related to the severity of chronic bronchitis symptoms; and (3) impairment of lung function from certain other diseases. The ideal group of non-bronchitics (NB 0) answered `no' to every symptomatology question (46·4%). Non-bronchitics grade 1 (NB 1) were either symptom-free or had only occasional cough and phlegm with either or both increased cough and phlegm and chest illness (24·2%). Non-bronchitics grade 2 (NB 2) complained of dyspnoea in the absence of persistent cough and phlegm (4·3%). Chronic bronchitics grade 1 (CB 1) had persistent cough and phlegm in the absence of any other complaint (11·3%). Chronic bronchitics grade 2 (CB 2) had the additional impairment of increased cough and phlegm and/or chest illness (8·1%). Grade 3 (CB 3) complained of dyspnoea with or without increased cough and phlegm (2·5%). Grade 4 (CB 4) had both dyspnoea and chest illness (3·2%). Lung function (FEV) in three of the groups of chronic bronchitics (CB 1, CB 2, CB 3: 21·9%) was no worse than in the two groups of non-bronchitics with complaints of other respiratory disorders (NB 1, NB 2: 28·6%). An overall comparison on a binary division between non-bronchitics and bronchitics hides the severity of some of the bronchitic groups. For this reason it is recommended that epidemiological studies of chronic bronchitis should separate the suggested grades of bronchitics (CB 1, 2, 3, and 4) and compare them with the ideal group of non-bronchitics (NB 0: 46·4%) which has the lowest prevalence of heart trouble and asthma and those who have had pneumonia.
对塔尔伯特港的10816名钢铁工人进行询问和检查后，划分出了七组相互排斥的非支气管炎患者和慢性支气管炎患者。这些组是根据对医学研究委员会关于咳嗽、咳痰、呼吸困难、咳嗽和咳痰增加以及胸部疾病的问卷的不同回答组合而成的。分组依据明确的标准：（1）每组有合理数量的男性；（2）肺功能损害（第一秒用力呼气容积）与慢性支气管炎症状的严重程度相关；（3）肺功能因某些其他疾病而受损。理想的非支气管炎组（NB 0）对每个症状问题都回答“否”（46.4%）。1级非支气管炎患者（NB 1）无症状，或仅有偶尔咳嗽和咳痰，伴有咳嗽和咳痰增加及胸部疾病中的一项或两项（24.2%）。2级非支气管炎患者（NB 2）在无持续性咳嗽和咳痰的情况下主诉呼吸困难（4.3%）。1级慢性支气管炎患者（CB 1）有持续性咳嗽和咳痰，无任何其他主诉（11.3%）。2级慢性支气管炎患者（CB 2）伴有咳嗽和咳痰增加及/或胸部疾病的额外损害（8.1%）。3级（CB 3）主诉有或无咳嗽和咳痰增加的呼吸困难（2.5%）。4级（CB 4）既有呼吸困难又有胸部疾病（3.2%）。三组慢性支气管炎患者（CB 1、CB 2、CB 3：21.9%）的肺功能（第一秒用力呼气容积）并不比两组有其他呼吸系统疾病主诉的非支气管炎患者（NB 1、NB 2：28.6%）差。对非支气管炎患者和支气管炎患者进行二元划分的总体比较掩盖了一些支气管炎组的严重程度。因此，建议慢性支气管炎的流行病学研究应区分所建议的支气管炎等级（CB 1、2、3和4），并将它们与理想的非支气管炎组（NB 0：46.4%）进行比较，该组心脏病、哮喘以及患过肺炎的患病率最低。
