吸烟和生物燃料所致慢性阻塞性肺疾病患者临床特征差异研究

发布时间：2018-06-26 00:23

本文选题：慢性阻塞性肺疾病 + 吸烟　；参考：《中国实用内科杂志》2014年10期

【摘要】：目的观察吸烟和生物燃料所致慢性阻塞性肺疾病(COPD)患者临床特征的差异。方法回顾性分析2011年3月至2014年3月在广州呼吸疾病研究所206例由吸烟和81例生物燃料导致的慢阻肺患者的临床资料,分别比较了两组患者的一般情况、临床症状、呼吸困难评分和合并症等方面的差异;肺功能和分级及急性加重的差异。结果 (1)一般情况的差异:吸烟所致慢阻肺患者中男性和女性的比例分别为83.5%和16.5%,生物燃料所致慢阻肺的患者中男性和女性的比例分别为14.8%和85.2%(χ2=27.2,P0.05)。吸烟所致慢阻肺患者多见于男性,而生物燃料所致慢阻肺患者多见于女性;性别矫正后,生物燃料所致的女性COPD患者的体重指数(BMI)低于吸烟所致的女性COPD患者的BMI。其他指标如年龄两组差异无统计学意义。(2)临床症状差异:生物燃料和吸烟所致慢阻肺患者的呼吸困难指数mMRC差异无统计学意义;生物燃料所致慢阻肺患者出现喘息症状多于吸烟所致慢阻肺的患者,分别为38.3%和11.1%(χ2=17.9,P0.05)。生物燃料所致慢阻肺患者合并过敏性疾病(如过敏性鼻炎、支气管哮喘)比例高于吸烟所致慢阻肺的患者,分别为43.2%和18%(χ2=16.1,P0.05);而吸烟所致慢阻肺患者合并肺癌比例高于生物燃料所致慢阻肺的患者,分别为7.77%和3.7%(χ2=9.7,P0.05)。(3)肺功能分级的差异:慢阻肺分级上,性别校正后生物燃料所致慢阻肺患者分级更多见于B级或D级,症状多。(4)急性加重的差异:生物燃料所致和吸烟所致的慢阻肺患者1年内急性加重次数无显著差异。结论吸烟和生物燃料所致的慢阻肺在临床特征上有很多差异:生物燃料所致慢阻肺患者多见于女性,BMI低,临床症状较多,合并症以过敏性鼻炎和支气管哮喘较多,慢阻肺分级多见于B级或D级。吸烟所致慢阻肺患者多见于男性,合并症以肺癌较多。
[Abstract]:Objective to observe the clinical characteristics of chronic obstructive pulmonary disease (COPD) caused by smoking and biofuel. Methods the clinical data of 206 patients with COPD caused by smoking and 81 patients with chronic obstructive pulmonary disease caused by biofuel in Guangzhou Institute of Respiratory Diseases from March 2011 to March 2014 were analyzed retrospectively. Differences in dyspnea score and complications, pulmonary function and grade, and acute exacerbation. Results (1) the difference of general conditions: the proportion of male and female were 83.5% and 16.5%, respectively, and the proportion of male and female were 14.8% and 85.2% respectively (蠂 227.2P 0.05). After sex correction, the body mass index (BMI) of female COPD patients induced by biofuel was lower than that of female COPD patients induced by smoking. There was no significant difference in other indexes such as age. (2) the difference of clinical symptoms: there was no significant difference in mMRC between patients with chronic obstructive pulmonary disease caused by biofuel and smoking. The wheezing symptoms in patients with chronic obstructive pulmonary disease caused by biofuel were 38.3% and 11.1% respectively (蠂 2 / 17.9 P 0.05). The proportion of patients with chronic obstructive pulmonary disease caused by biofuel (such as allergic rhinitis, bronchial asthma) was higher than that of patients with chronic obstructive pulmonary disease caused by smoking. 43.2% and 18% (蠂 2 / 16.1%), respectively (蠂 2 / 16. 1%), but the proportion of lung cancer in patients with chronic obstructive pulmonary disease induced by smoking was higher than that in patients with chronic obstructive pulmonary disease caused by biofuel (7.77% and 3.7% respectively) (蠂 2 9.7U P 0.05). (3). After sex correction, the classification of patients with chronic obstructive pulmonary disease caused by biofuel was more frequently seen in grade B or D, with more symptoms. (4) acute exacerbation: there was no significant difference in acute exacerbation between biofuel induced COPD patients and smoking induced COPD patients within one year. Conclusion there are many differences in clinical characteristics between chronic obstructive pulmonary disease caused by smoking and biofuel. The patients with chronic obstructive pulmonary disease caused by biofuel are more common in women with low BMI, more clinical symptoms, and more allergic rhinitis and bronchial asthma. The grade of chronic obstructive pulmonary disease is often seen in grade B or D. Smoking-induced COPD is more common in men and lung cancer is more complicated.
【作者单位】：呼吸疾病国家重点实验室广州医科大学第一附属医院;广东食品药品职业学院;
【基金】：广东省自然科学基金(s2013010016665)
【分类号】：R563.9

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