湘黔部分医院2017—2023年度慢性阻塞性肺疾病初诊患者临床特征及吸入药物变迁  

Clinical characteristics and changes in inhaled drugs of newly diagnosed patients with chronic obstructive pulmonary disease in some hospitals in Hunan and Guizhou from 2017 to 2023

作　　者：简帮旭 朱军 蒋爱云 陈平[2] 宋庆 邓玎玎 Jian Bangxu;Zhu Jun;Jiang Aiyun;Chen Ping;Song Qing;Deng Dingding(Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Shaoyang University,Shaoyang 422001,China;Department of Pulmonary and Critical Care Medicine,the Second Xiangya Hospital,Central South University,Research Unit of Respiratory Disease,Central South University,Hunan Respiratory and Critical Disease Clinical Medical Research Center,Diagnosis and Treatment Center of Respiratory Disease,Central South University,Changsha 410011,China)

机构地区：[1]邵阳学院附属第一医院呼吸与危重医学科,邵阳422001 [2]中南大学湘雅二医院呼吸与危重症医学科,中南大学呼吸疾病研究所,湖南省呼吸与危重症疾病临床医学研究中心,中南大学呼吸疾病诊疗中心,长沙410011

出　　处：《中国医师杂志》2024年第6期817-822,共6页Journal of Chinese Physician

基　　金：国家自然科学基金(81970044,82270045);湖南省科技创新计划项目(2018SK51905)。

摘　　要：目的比较湘黔部分医院2017—2023年度初诊慢性阻塞性肺疾病(慢阻肺)患者的临床特征及吸入性药物的变迁,以进一步了解慢阻肺诊治现状。方法该横断面研究纳入2017年1月1日至2023年12月31日在我国13家医院呼吸与危重症医学科初诊的稳定期慢阻肺患者,根据患者初次就诊的时间分为7组:2017年度、2018年度、2019年度、2020年度、2021年度、2022年度及2023年度组,收集患者的基本资料、第1秒用力呼气容积占预计值百分比(FEV_(1)%pred)、第1秒用力呼气容积/用力肺活量(FEV_(1)/FVC)、慢阻肺评估测试(CAT)评分、过去一年急性加重次数及吸入性药物方案等。结果2017—2019年度就诊的慢阻肺患者CAT评分显著高于2020—2023年度(均P<0.05);2017—2023年度慢阻肺患者的FEV_(1)%pred及FEV_(1)/FVC呈升高趋势;2017—2023年度间使用长效抗胆碱药物(LAMA)的比例呈逐渐下降趋势,2023年度使用单药LAMA的慢阻肺患者比例为8.0%(134/1665)。2018年度、2019年度及2020年度及2021年度使用双支气管扩张剂患者的比例逐年升高,且2021年度、2022年度和2023年度使用双支气管扩张剂慢阻肺患者的比例趋于稳定,组间差异无统计学意义(P>0.05)。2020年度和2021年度使用三联吸入药物的慢阻肺患者比例最低(P<0.05),2017年,2018年,2019年,2022和2023年使用三联吸入的慢阻肺患者比例分别为45.2%(364/806)、54.0%(730/1352)、55.5%(742/1337)、45.8%(717/1565)和51.1%(851/1665)。2017—2023年度慢阻肺初诊患者的吸入处方与慢性阻塞性肺疾病全球倡议(GOLD)文件的依从性分别为47.9%(386/806)、35.1%(474/1352)、33.7%(451/1337)、40.3%(405/1005)、31.2%(372/1193)、28.4%(445/1565)及58.8%(979/1665)。结论随着时间迁移,初诊慢阻肺患者的临床症状有所减轻,说明就诊时间有前移趋势;双支气管扩张剂使用比例增加,三联吸入药物使用的比例较高,GOLD文件的依从性仍然不理想。Objective To compare the clinical characteristics and changes in inhaled drugs of newly diagnosed chronic obstructive pulmonary disease(COPD)patients in some hospitals in Hunan and Guizhou from 2017 to 2023,in order to further understand the current status of COPD diagnosis and treatment.Methods This cross-sectional study included stable COPD patients who were initially diagnosed in the respiratory and critical care departments of 13 hospitals in China from January 1,2017 to December 31,2023.They were divided into 7 groups based on the time of their initial visit:the 2017,2018,2019,2020,2021,2022,and 2023 groups.Basic information of the patients,the percentage of forced expiratory volume per second(FEV_(1)%pred),FEV_(1)/forced vital capacity(FVC),COPD assessment questionnaire(CAT)scores,the number of acute weightings in the past year,and inhalation drug regimens were collected.Results The CAT scores of patients with COPD who visited from 2017 to 2019 were significantly higher than those from 2020 to 2023(all P<0.05);The FEV_(1)%pred and FEV_(1)/FVC of patients with COPD showed an increasing trend from 2017 to 2023;The proportion of patients using long-acting muscarine anticholinergic(LAMA)gradually decreased between 2017 and 2023,with 8.0%(134/1665)of patients with COPD using single drug LAMA in 2023.The proportion of patients using double branch dilators has been increasing year by year in 2018,2019,2020,and 2021,and the proportion of patients using double branch dilators for COPD has stabilized in 2021,2022,and 2023,with no statistically significant difference between groups(P>0.05).The proportion of patients with COPD who used triple inhalation drugs was the lowest in 2020 and 2021(P<0.05).In 2017,2018,2019,2022,and 2023,the proportion of patients with COPD who used triple inhalation drugs was 45.2%(364/806),54.0%(730/1352),55.5%(742/1337),45.8%(717/1565),and 51.1%(851/1665),respectively.The compliance with inhalation prescriptions and Global Initiative for Chronic Obstructive Pulmonary Disease(GOLD)documents

关 键 词：肺疾病 慢性阻塞性 投药 吸入 慢性阻塞性肺疾病全球倡议 

分 类 号：R563.9[医药卫生—呼吸系统]