GOLD2014对慢性阻塞性肺疾病住院患者病情评估的临床意义  

Assessment of inpatients with chronic obstructive pulmonary disease by using the new GOLD 2014

作　　者：赵莹[1] 刘希芝[1] 唐文慧[1] 范明鑫[1] 付莉[1] 季红[1] 回银娜[1] 张永祥[1] 

机构地区：[1]北京市大兴区人民医院呼吸科,102600

出　　处：《国际呼吸杂志》2015年第15期1121-1125,共5页International Journal of Respiration

摘　　要：目的①了解我院COPD患者按照GOLD2014分类方法A～D组患者的分布情况及与合并症之间的关系；②对GOLD2014与G（）LD2007COPD的评估方法进行比较，观察二者的优缺点。方法对我院109例COPD患者分别依据GOLD2014与GOI．D2007进行分级，并比较2种评估方法。结果COPD患者分布情况为：D组46例（42．2％），B组30例（27．5％），A组22例（20．1％），C组11例（10．1％）；主要合并症依次为：高血压46．8％、冠状动脉粥样硬化性心脏病33．9％、高脂血症23．9％、糖尿病11．9％。D组合并冠状动脉粥样硬化性心脏病明显高于A组和c组，差异有统计学意义（P=0．012，P=0．002）。应用GOLD2014分类方法，严重的D组46例，而应用GOI．D2007分级方法，最严重的GOLD4级为10例。结论按照GOLD2014新分类方法，COPD患者以D组和B组为主，合并症以心血管疾病为主，且D组的冠状动脉粥样硬化性心脏病者最多；GOLD2014分级方法较GOLD2007分级方法对患者的病情评估更全面。Objective This study aimed to determine chronic obstructive pulmonary disease （COPD） patients distribution （group A-D） by the new Global Initiative for Chronic Obstructive Lung Disease （GOLD） update （2014） and evaluate their relationships with comorbid diseases. Furthermore, the new 2014GOLD grading was compared with 2007 GOLD staging in order to investigate the advantages and disadvantages. Methods We obtained data of 109 patients with COPD in our hospital. Data of patients with COPD were used to distribute and compare the abilities of the old stratification（GOLD 2007） and the new stratification （GOLD 2014）. Results Of 109 patients,46 （42.2%） were in new GOLD 2014 patient group D, 30 （27.5%） were B,22 （20.1%） were A, and 11 （10.1%） were C. There were several important comorbid disease in COPD. Hypertension, coronary atheroscIerotic heart disease, hyperlipemia, and diabetes were present in 46.8%, 33.9%, 23.9% and 11.9%, respectively. Analyses showed that a higher risk of coronary atherosclerotic heart disease in group D was than in group A and C （ P =0. 012, P = 0. 002）,respectively. The new classification results in more individuals belongs to the most severe group, group D,in the 2014 （ n =46） in comparison with only 10 individuals belonging to the most severe group, group 4,in the 2007 classification. Conclusions The 2014 GOLD grading produces mainly in D and B patient groups. Cardiovascular disease is the most important comorbidities. In addition, coronary atheroselerotie heart disease is frequently seen in group D. Compared with the old stratification （GOLD 2007） ,the new stratification（GOLD 2014） provides better assessment.

关 键 词：慢性阻塞性肺疾病 合并症 指南 

分 类 号：R47[医药卫生—护理学]