慢阻肺筛查问卷结合肺功能检查在早期诊断慢阻肺中的意义

Significance of chronic obstructive lung screening questionnaire combined with pulmonary function examination in the early diagnosis of chronic obstructive pulmonary disease

目的在受检者进行肺功能检查前通过问卷调查进行筛查,分析慢性阻塞性肺疾病(简称慢阻肺)患病率及危险因素,据此探讨慢阻肺筛查问卷结合肺功能检查在早期诊断慢阻肺中的意义,找出提高慢阻肺早期诊断检出率的合理方案。方法选取2015年8月~2016年4月在我院进行肺功能检查的495例受检者作为本次研究的调查对象,自主设计调查问卷用于本次调查研究,调查问卷的设计依据国际初级气道保健组织(IPAG)和国际呼吸道疾病基层医疗组织(IPCRG),在进行肺功能测定前发放调查问卷,由肺功能室操作者对所有研究对象进行统一的问卷调查。根据肺功能的检测结果将调查对象分为两组,分别为慢阻肺组和非慢阻肺组,通过对两组调查对象的一般资料进行比较,从而对患慢阻肺的单因素危险因素进行筛选,最后采用多因素非条件logistic回归对筛选出的危险因素进行分析。结果 495例受检者中,检出慢阻肺患者103例,检出率为20.8%。以问卷调查总分≥17分为界值,调查问卷对诊断慢阻肺的敏感性85.43%,特异性80.73%,阳性预测值80.73%,阴性预测值96.11%,尤登指数0.9273;单因素分析结果显示,年龄、性别、BMI、学历、吸烟史、粉尘接触史均数引起慢阻肺的相关因素(P<0.05);多因素logistic回归分析的结果显示,慢阻肺发生的独立危险因素主要包括男性、高龄、低BMI吸烟、粉尘接触史和低学历等五点(P<0.05)。结论慢阻肺筛查问卷可以起到初步筛查慢阻肺高危人群的作用,与肺功能检查相结合可以达到有效提升慢阻肺早期诊断率的目的,可以进行推广应用。

Objective To analyze the prevalence and risk factors of chronic obstructive pulmonary disease by means of questionnaire before the examination of pulmonary function, and to explore the significance of the questionnaire combined with pulmonary function test in the early diagnosis of chronic obstructive pulmonary disease, and to find a reasonable plan to improve the detection rate of early diagnosis of chronic obstructive pulmonary disease. Methods A total of 495 patients who underwent pulmonary function tests in our hospital from August 2015 to April 2016 were selected as the subjects of this study, self-designed questionnaire was used for this investigation. The questionnaire was designed according to the international primary air health organization （IPAG） and the international respiratory disease basic medical organization （IPCRG）.Before the pulmonary function test, the questionnaire was issued, and all the subjects were investigated with a uniform questionnaire. According to the detection results of lung function, the subjects were divided into two groups, namely, COPD group and non-COPD group. By comparing the general data of the two groups of subjects, the single factor risk factors of COPD were screened. At last, the risk factors were analyzed by multi factor non conditional logistic regression. Results Of the 495 patients,103 patients of chronic obstructive pulmonary disease were detected, the detection rate was 20.8%.The total score of questionnaire≥17 was divided into the boundary value, the sensitivity of the questionnaire to the diagnosis of COPD was 85.43%,the specificity was 80.73%,the positive predictive value was 80.73%,the negative predictive value was 96.11%,especially index was 0.9273.Single factor analysis showed that age, gender, BMI, education, smoking history and dust exposure history were all related factors （P 〈0.05）.The results of multivariate logistic regression analysis showed that the independent risk factors of COPD mainly included male, old age, low BMI smoking, dust exposure history and low education level （P 〈0.05）. Conclusion The chronic obstructive pulmonary disease screening questionnaire can play a preliminary screening of the role of high-risk groups of COPD, and the combination with pulmonary function examination can effectively improve the early diagnosis rate of COPD, can be used to promote the application.