环境因素对慢性阻塞性肺疾病候鸟人群的影响  

Influence of environmental factors on the migratory birds population with chronic obstructive pulmonary disease

作　　者：闫鹏[1] 林容[2] 贾艳红[1] 刘鹏飞[3] 肖坤[3] 刘丹[3] 关伟[3] 谭红研 解立新[3] 

机构地区：[1]解放军总医院海南分院呼吸科,海南省三亚市572013 [2]海南省三亚市人民医院呼吸科 [3]解放军总医院呼吸科

出　　处：《中华医学杂志》2015年第36期2924-2927,共4页National Medical Journal of China

基　　金：中央保健科研课题（W2013BJ11）;海南省重点科技计划项目（ZDXM20120055）

摘　　要：目的 探讨环境因素对慢性阻塞性肺疾病（慢阻肺）候鸟人群的影响.方法 收集2012年9月至2014年5月解放军总医院海南分院及三亚市人民医院就诊的北京地区稳定期候鸟慢阻肺患者82例;10月至次年4月（表述为冬季）,在三亚对入组患者分别行慢阻肺评价试验评分（CAT）、改良呼吸困难分级评分（mMRC）,每2个月随访1次;5月至9月（表述为夏季）待候鸟慢阻肺患者返回北京地区后,对稳定期候鸟慢阻肺患者再次行CAT评分、mMRC评分,每2个月随访1次,比较候鸟慢阻肺患者改变生活环境后自身评分的变化.观察期间若患者出现急性加重或因急性加重住院治疗,则做相应的记录,在患者进入稳定期1个月后再次评分.同时在全国城市空气质量发布平台每天记录空气质量指数（AQI）,并记录当地气温及相对湿度.结果 候鸟慢阻肺患者在三亚的CAT总评分显著低于北京[（20.0±8.0）比（26.4±7.1）分,P＜0.001];在三亚的mMRC总评分显著低于北京[（1.9±0.8）比（2.9±0.9）分,P =0.001],根据最新指南,用mMRC评价候鸟慢阻肺患者,其分级由D降至C,CAT评分的变化未引起分级变化.三亚冬季与北京夏季的平均气温差异无统计学意义[（23.1±4.2）比（24.3±2.3）℃,P=0.674];三亚冬季的AQI显著低于北京夏季[（49.4±8.9）比（113.1±14.2） μg/m3,P ＜0.001];三亚冬季的相对湿度显著高于北京夏季[（90.6±4.9）％比（58.0±10.0）％,P=0.001].结论 候鸟慢阻肺患者在空气质量更好、相对湿度更高的地区,其生活质量和活动耐量明显提高.Objective To explore the influence of environment factors on the migratory birds population with chronic obstructive pulmonary disease （MDCOPD）.Methods A total of 82 stable MDCOPD patients from Beijing area,who went to Hainan Branch of PLA General Hospital and the People＇s Hospital of Sanya for treatment between September 2012 and May 2014,were recruited in this study.At Sanya,from October to April of the following year （wintertime）,all the patients were evaluated by COPD assessment test （CAT） and modified medical research council （mMRC） questionnaire,and follow-up was performed every 2 months.From May to September （summertime）,when the MDCOPD patients came back to Beijing area,the patients were evaluated by CAT and mMRC questionnaire again,and still follow-up was performed every 2 months.The scores of before and after living environment changed were compared.Acute exacerbations or hospitalizations were recorded if any occurred in the patients during the follow up period,and the patients were reevaluated by the two questionnaires 1 month later after they became stable.At the same time,the daily air quality index （AQI） from the national urban air quality publishing platform and the temperature and relative humidity from the local weather network were recorded.Results The score of CAT in Sanya was significantly lower than that in Beijing （（20.0 ±8.0） vs （26.4 ±7.1） scores,P 〈0.001）;the score of mMRC in Sanya was also significantly lower than Beijing （（1.9 ±0.8） vs （2.9 ±0.9） scores,P =0.001）.Based on the latest guidelines,the classification of COPD patients changed from D （in Beijing）to C （in Sanya） according to mMRC scores,while the CAT scores from the two cities did not cause the change of classification.The difference of temperature between wintertime of Sanya and summertime of Beijing was not significant （（23.1 ±4.2） vs （24.3 ±2.3） ℃,P =0.674）;the wintertime＇s AQI in Sanya was significantly lower than the summertime＇s AQI in Bei

关 键 词：肺疾病 慢性阻塞性 环境污染 迁徙 评分 

分 类 号：R563.9[医药卫生—呼吸系统]