摘要
目的探讨呼气峰流量的检测对基层医院筛查早期慢性阻塞性肺疾病的价值。方法从2018年2月~2019年7月我院心肺科住院患者中应用随机整群抽样方式选取30000例慢性阻塞性肺疾病患者作为研究对象,分别收集患者的基本临床资料、进行6min步行测试、慢阻肺评估测试(CAT)、改良英国医学研究委员会呼吸问卷(mMRC)调查与圣乔治呼吸问卷(SGRQ)调查,同时测量患者的PEF;应用Logistic回归分析慢阻肺患者能否被峰流速仪筛出的影响因素。结果将PEF占预计值百分比(PEF%pred)的80%作为截断值,共筛查出29883例,漏诊例数为117例;相比于CAT<10分、mMRC<2分、SGRQ<25分的患者,CAT≥10分、mMRC≥2分、SGRQ≥25分的患者的敏感性明显较高,峰流速仪PEF筛查对近1年无急性加重的患者的敏感性为76.49%,对于急性加重次数少于2次的敏感性为71.96%,对于急性加重次数超过2次的敏感性为93.26%;将92%作为截断值时,PEF对于筛查早期慢性阻塞性肺疾病具有更高的敏感性;经Logistic回归分析显示,CAT评分与SGRQ总分是主要的两个影响因素。结论呼气峰流量的检测对基层医院筛查早期慢性阻塞性肺疾病具有较高的价值,不仅能够明确患者是否患病,同时能够明确患者的疾病程度。
Objective To explore the value of peak expiratory flow(PEF)detection in screening early chronic obstructive pulmonary disease(COPD)in primary hospitals.Methods A total of 30000 COPD inpatients in the cardiopulmonary department of our hospital from February 2018 to July 2019 were selected using random cluster sampling.The basic clinical data of the patients,6-minute walking test,COPD assessment test(CAT),modified British Medical Research Council Respiration Questionnaire(mMRC)and St.George's Respiratory Questionnaire(SGRQ),and the results of PEF were observed and collected;the influencing factors for screening COPD were analyzed using Logistic regression analysis.Results Taking 80%predicted values of PEF(PEF%pred)as the cutoff value,a total of 29,883 cases were screened out,and 117 cases were missed diagnosis.Compared with patients with CAT<10,mMRC<2,and SGRQ<25,the sensitivity of patients with CAT≥10,mMRC≥2,and SGRQ≥25 was significantly higher.The sensitivity of PEF screening for patients with no acute exacerbation in the past year was 76.49%,for patients with acute exacerbations less than twice was 71.96%,and for patients with acute exacerbations more than twice was 93.26%.When 92%was used as the cutoff value,PEF had a higher sensitivity for screening early chronic obstructive lungs.Logistic regression analysis showed that the CAT score and the total SGRQ score were the two main influencing factors.Conclusion The detection of PEF is of great value for screening COPD in early stage in primary hospitals.It can not only determine whether the patient is sick,but also the severity of the patient's disease.
作者
谭石党
陈永红
关云龙
TAN Shidang;CHEN Yonghong;GUAN Yunlong(People's Hospital of Yangjiang High-tech Industrial Development Zone,Guangdong,Yangjiang 510610,China)
出处
《中国医药科学》
2020年第13期251-254,共4页
China Medicine And Pharmacy
基金
广东省阳江市医疗卫生类科技计划项目(阳科通[2019]50号)。
关键词
呼气峰流量
基层医院
早期慢性阻塞性肺疾病
筛查
Peak expiratory flow
Primary hospitals
Early chronic obstructive pulmonary disease
Screening
