慢性阻塞性肺疾病合并症的研究

Comorbidities of chronic obstructive pulmonary disease： a cross-sectional retrospective study in a tertiary hospital

目的 研究慢性阻塞性肺疾病（COPD）合并症的患病情况.方法 依据2011版慢性阻塞性肺疾病诊断、处理和预防全球策略提出对COPD合并症进行综合评估的指导思想,对2010年1月至2012年5月间在北京协和医院急诊/住院的COPD患者的病案资料进行了回顾性分析.结果 急诊/住院COPD患者共492例,男366例,女126例,平均年龄（71.5±9.7）岁；其中肺功能诊断的COPD 235例,占47.9％.492例患者分布在全院29个科室,其中AECOPD患者101例.492例患者中,86.0％合并一种或一种以上的合并症,其中高血压、肺部感染的患病率分别为49.4％、41.3％；心功能不全、冠状动脉粥样硬化性心脏病和糖尿病的患病率分别为25.6％、24.2％和23.2％；房颤、肺癌和COPD合并哮喘的患病率分别为13.4％、10.0％和7.1％；代谢综合征、骨质疏松、焦虑抑郁存在明显的低诊断.结论 合并症在COPD患者中非常普遍存在,尤其是心血管系统合并症更是常见；临床各科医师对COPD合并症的评估尚需提高.

Objective To study the prevalence of comorbidities in patients with chronic obstructive pulmonary disease （COPD）.Methods We retrospectively reviewed medical charts of patients admitted to Peking Union Medical College Hospital between January 1,2010 and May 1,2012 with a diagnosis of COPD.Comorbidities were identified using the criteria of global strategy for the diagnosis,management,and prevention of chronic obstructive pulmonary disease （GOLD revised 2011）.Results Of 492 COPD patients,366 are males and 126 females with mean age of （71.5±9.7） years.Among them,235 patients （47.9%） were diagnosed by the spirometry.They were admitted to 29 departments of the hospital.101 patients were admitted because of AECOPD.86.0% of patients has one or more comorbidities.The prevalence of hypertension is 49.4%,pulmonary infection 41.3%,heart failure 25.6%,coronary heart disease 24.2%,diabetes 23.2%,atrial fibrillation 13.4%,lung cancer 10.0%,and COPD overlapped with asthma 7.1%.Metabolic syndrome,osteoporosis and anxiety/depression were significantly underdiagnosed.Conclusions Comorbidities,especially cardiovascular comorbidities,are common in COPD.Increased medical attention is warranted.