两种方法筛查宜宾市60岁以上居民慢性阻塞性肺疾病的一致性研究  

Consistency of two methods in screening COPD among residents over 60 years old in Yibin City

作　　者：杜明明 董礼 吕俊[1] DU Ming-ming;DONG Li;LV Jun(Department of Respiratory and Critical Care Medicine, Yibin Second People′s Hospital, Yibin 644000, China)

机构地区：[1]宜宾市第二人民医院呼吸与危重症医学科,四川省宜宾市644000

出　　处：《实用老年医学》2021年第2期141-144,共4页Practical Geriatrics

基　　金：宜宾市科技局项目(2018YY008)。

摘　　要：目的比较基于症状的COPD筛查问卷和慢性阻塞性肺疾病全球倡议(GOLD)2017标准在60岁以上居民COPD筛查中的一致性。方法于2019年1~12月采用多阶段抽样抽取宜宾市60岁以上居民744例,分别采用基于症状的COPD筛查问卷和肺功能检查调查COPD的患病情况,比较2种方法在诊断结果上的一致性。结果以基于症状的COPD筛查问卷评分≥16.5分(可疑)和≥19.5分(高危)为截点,诊断COPD人数分别为127例(17.1%)和86例(11.6%),不同年龄、BMI和吸烟量的可疑人数和高危人数检出率差异均有统计学意义,年龄越大、BMI越低、吸烟量越多者,检出率越高(P<0.05)。采用肺功能检查GOLD 2017标准共确诊COPD 81例,患病率为10.9%,不同年龄、BMI和吸烟量居民患病率差异有统计学意义(P<0.05)。以GOLD 2017为金标准,分别以基于症状的COPD筛查问卷评分16.5分和19.5分为截点诊断COPD,其kappa值分别为0.512和0.791,灵敏度分别为74.1%和84.0%,特异度分别为89.9%和97.3%。结论基于症状的COPD筛查问卷适用于60岁以上人群的COPD筛查,以19.5分为截点能比较准确地反映个体的肺功能状况,具有较高的一致性、灵敏度和特异度。Objective To compare the consistency of symptom-based questionnaire for identifying chronic obstructive pulmonary disease(COPD)and Global Initiative for Chronic Obstructive Lung Disease(GOLD)2017 standard in screening COPD among the residents over 60 years old in Yibin.Methods From January to December 2019,744 residents over 60 years old were selected from Yibin by multi-stage sampling,and they were diagnosed by symptom-based questionnaire for identifying COPD and pulmonary function test respectively.The consistency of two methods was compared in diagnosing COPD.Results With a score of symptom-based questionnaire for identifying COPD of 16.5 or 19.5,a total of 127 or 86 residents were diagnosed as COPD with a detection rate of 17.1%or 11.6%respectively.There was significant difference in the detection rate of COPD among the residents with different age,body mass index(BMI)or smoking state(P<0.05).Eighty-one cases were diagnosed as COPD by pulmonary function according to GOLD 2017 with a prevalence of 10.9%,and significant differences were observed among the residents with different age and smoking(P<0.05).With GOLD 2017 as the golden standard,symptom-based questionnaire for identifying COPD score with 16.5 or 19.5 as cut-off showed a kappa of 0.512 and 0.791,sensitivity of 74.1%and 84.0%,specificity of 89.9%and 97.3%,respectively.Conclusions Symptom-based questionnaire for identifying COPD is suitable for COPD screening among the residents over 60 years old.Taking 19.5 as cut-off for diagnosing COPD can accurately reflect the lung function of individuals,with high consistency,sensitivity and specificity.

关 键 词：慢性阻塞性肺疾病 基于症状的COPD筛查问卷 肺功能 一致性 

分 类 号：R563[医药卫生—呼吸系统]