社区慢性阻塞性肺疾病的筛查流程和技术手段

发布时间：2019-06-21 07:27

【摘要】：目的探讨一套有效的慢性阻塞性肺疾病的筛查流程和技术手段。方法采用统一的流行病调查表,以整群随机抽样的方法,以家庭为单位,对古美社区的居民进行问卷调查,并进行实验室、影像学及社区肺功能检查,对其结果进行调查分析。结果共调查413例调查对象,男194例,女219例,平均年龄(68.38±7.39)岁;用Vitalograph COPD-6进行社区肺功能检查,共筛出37例阳性患者,占总筛查人数的9.0%;剔除第1秒末用力肺活量(FEV1)与用力肺活量(FVC)比值异常的患者(比值为7.8%)后,共筛出36例阳性患者,占总筛查人数的8.7%。后续差异性和回归分析均以剔除异常值后的数据进行处理。经χ~2检验,筛查对象有无气喘、吸烟累计是否超过5包,会带来Vitalograph'COPD-6检查结果的显著差异(P0.05);经t检验,年龄、淋巴细胞比值、中性粒细胞比值与Vitalograph COPD-6检查结果显著相关(P0.05)。多因素Logistic回归结果显示,年龄大、有气喘、淋巴细胞比值低,会显著增加Vitalograph COPD-6检查结果阳性风险(P0.05)。结论古美社区COPD患病率8.7%,气喘、吸烟、年龄、淋巴细胞比值、中性粒细胞比值与Vitalograph COPD-6检查结果显著相关。有效的社区筛查诊断工具,应该将高危因素问卷、生化检查和肺功能初筛进行结合检测,可能具有一定的意义。
[Abstract]:Objective to explore an effective screening process and technical method for chronic obstructive pulmonary disease (COPD). Methods A unified epidemiological questionnaire was used to investigate the residents of Gumei community by cluster random sampling, and laboratory, imaging and community pulmonary function tests were carried out, and the results were investigated and analyzed. Results A total of 413 subjects, including 194 males and 219 females, with an average age of (68.38 卤7.39) years, were investigated, and 37 positive patients (9.0%) were screened out by Vitalograph COPD-6. After excluding the patients with abnormal ratio of forced vital capacity (FEV1) to forced vital capacity (FVC) at the end of the first second (7.8%), a total of 36 positive patients, accounting for 8.7% of the total screening population, were screened. The subsequent difference and regression analysis were processed by the data after excluding the abnormal value. The results of Vitalograph'COPD-6 test were significantly different (P 0.05), and t test, age, lymphocytes ratio and neutrophil ratio were significantly correlated with the results of Vitalograph COPD-6 test (P 0.05), and there was a significant difference in the results of Vitalograph COPD-6 test between the screening subjects and whether the subjects had asthma and whether the cumulative smoking was more than 5 packs (P 0.05). Multivariate Logistic regression results showed that age, asthma and low ratio of lymphocytes significantly increased the positive risk of Vitalograph COPD-6 (P 0.05). Conclusion the prevalence of COPD in Gumei community is 8.7%. Asthma, smoking, age, lymphocyte ratio and neutrophil ratio are significantly correlated with the results of Vitalograph COPD-6. Effective community screening and diagnosis tools should be combined with high risk factor questionnaire, biochemical examination and primary screening of lung function, which may have certain significance.
【作者单位】：上海市古美社区卫生服务中心;
【分类号】：R563.9

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