不同程度呼吸困难慢阻肺患者诊治认知研究  

Perception on Diagnosis and Treatment in COPD Patients with Dyspnea of Different Severities

作　　者：吴国霞 米文君 陈亚红[2] WU Guo-xia;MI Wen-jun;CHEN Ya-hong(Department of Respiratory Disease,Yanqing District Hospital,the Third Hospital of Peking University and Capital Medical University,Beijing 102100,China;Department of Respiratory Disease and Critical Care Medicine)

机构地区：[1]北京大学第三医院延庆区医院首都医科大学延庆教学医院呼吸科,北京102100 [2]北京大学第三医院呼吸与危重症医学科,北京100191

出　　处：《河北北方学院学报（自然科学版）》2018年第4期5-10,共6页Journal of Hebei North University:Natural Science Edition

基　　金：中华医学会临床医学慢性呼吸道疾病科研专项资金(No.07010360044)

摘　　要：目的探讨不同程度呼吸困难慢阻肺患者对诊治的认知。方法选取稳定期慢阻肺患者177例,采用横断面研究方法,根据mMRC评分分为轻度呼吸困难(mMRC=0~1)和中重度呼吸困难(mMRC=2~4),其中轻度呼吸困难129例(72.9%),中重度呼吸困难48例(27.1%)。研究不同程度呼吸困难慢阻肺患者认知、态度和行为对疾病诊断和治疗的影响。结果轻度呼吸困难和中重度呼吸困难患者年龄、BMI、医保和收入等差异无统计学意义(P>0.05);中重度患者的吸烟包年显著高于轻度患者(P<0.05);中重度患者肺功能较差,医生告知肺气肿和慢阻肺的比例较高(P<0.01);较多中重度患者知道吸入型激素有副作用(P<0.05),认为慢阻肺需要联合治疗(P<0.05)和长期治疗(P<0.01);与轻度患者相比,较多的中重度患者经常使用抗生素(P<0.05)。结论不同程度呼吸困难的慢阻肺患者在临床特征、诊治过程中的行为以及对慢阻肺相关知识的认知存在一定的差异,需给予个体化治疗。Objective To explore the perception on the diagnosis and treatment in patients with chronic obstructive pulmonary disease(COPD)with dyspnea of different severities.Methods 177 patients with stable COPD were selected and divided into mild the dyspnea group(mMRC=0~1)and the moderate or severe dyspnea group(mMRC=2~4)according to mMRC score.129 cases(72.9%)had mild dyspnea,and 48 cases(27.1%)had moderate or severe dyspnea.A cross-sectional study was used to study the influences of cognition,attitude and behavior on the diagnosis and treatment of patients with respiratory dyspnea and COPD.Results There was no difference in age,BMI,health care and income between two groups(P>0.05).The pack-year of moderate or severe dyspnea patients was obviously higher than that of patients with mild dyspnea(P<0.05).Lung function of patients with moderate or severe dyspnea were worse than those of patients with mild severe dyspnea;More patients with moderate or severe dyspnea were diagnosed emphysema and COPD(P<0.01).More patients with moderate or severe dyspnea knew side effects in inhaled hormone(P<0.05),and thought COPD needs combined treatment(P<0.05)and long-term care(P<0.01).Compared with patients with mild dyspnea,more patients with moderate or severe dyspnea often used antibiotics(P<0.05).Conclusions There were difference in the clinical characteristics,behavior in diagnosis and treatment and knowledge of COPD between COPD patients with dyspnea of different severities.COPD patients should be given individualized therapy.

关 键 词：慢性阻塞性肺疾病 呼吸困难 治疗 认知 行为 

分 类 号：R563.9[医药卫生—呼吸系统]