慢性阻塞性肺疾病急性加重风险预警体系专家调查

Investigation of the Expert Questionnaire on Risk Early Warning System for Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的通过专家问卷调查筛选慢性阻塞性肺疾病急性加重(AECOPD)的风险预警因素,建立风险预警体系。方法基于前期研究结果制定AECOPD风险预警专家问卷,遴选呼吸病领域30名专家进行问卷调查,采用均数和满分率评价专家意见集中程度,采用百分权重法对风险因素及体系进行赋权,制定风险因素删除标准,结合专家意见形成AECOPD风险预警因素和体系。结果发放问卷30份,回收30份,专家积极系数为100%。风险预警体系包括患者基本情况、疾病情况、临床症状、生存质量、生物学信息、中医证候6个方面,专家意见相对集中的风险因素有临床症状(均数4.8333)、疾病情况(4.7667)、吸烟史(4.9333)、疾病严重程度(4.9000)、近一年急性加重次数(4.8667)、喘息(4.9000)等。根据综合权重系数大小排在前列的风险因素有慢性阻塞性肺疾病评估测试(权重系数0.0178)、圣乔治呼吸疾病问卷(0.0172)、喘息(0.0123)、胸闷(0.0118)、咳嗽(0.0116)、咯痰(0.0116)等。结论风险预警体系包括患者疾病情况、临床症状、生存质量、中医证候等6个方面,吸烟史、疾病严重程度、近一年急性加重次数等可以作为AECOPD的风险预警因素,对指导临床预防AECOPD发生具有指导作用。

Objective To establish the system of early warning for acute exacerbation by screening risk factors of acute exacerbation of chronic obstructive pulmonary disease（ AECOPD） through expert questionnaires. Methods The expert questionnaire for acute exacerbation of AECOPD risk early warning was formulated based on the previous studies results. The questionnaires were conducted by 30 experts in the respiratory field. The concentration degree of expert opinions was evaluated with mean and full mark rate. The risk factors and system were determined by percentage weighting method. The deleting standard for risk factors was established. The early warning risk factors and system of AECOPD were formed referring to experts＇ opinions. Results All of the 30 distributed questionnaires were recovered. The positive coefficient of the experts was 100. 0%. The early warning risk system included 6 aspects of patients＇ basic condition,diseases condition,clinical symptoms,quality of life,biological information and traditional Chinese medicine（ TCM） syndrome. Experts＇ opinion focused on clinical symptoms（ mean value 4. 8333）,the conditions of COPD（ 4. 7667）,smoking history（ 4. 9333）,the severity of COPD（ 4. 9000）,acute exacerbations in the past year（ 4. 8667,）,and wheezing（ 4. 9000） etc. The risk factors ranked according to the size of the weights were COPD＇ assessment and test（ weight coefficient 0. 0178）,SGRQ（ 0. 0172）,wheezing（ 0. 0123）,chest tightness（ 0. 0118）,cough（ 0. 0116）,sputum（ 0. 0116）,etc. Conclusion The early warning risk system included 6 aspects of patients＇ diseases conditions,clinical symptoms,quality of life,TCM syndrome etc. Some indexes could be used as AECOPD risk early warning factors,such as smoking history,the severity of COPD,the frequency of AECOPD for the past year,syndrome transformation etc.,which has positive effects in reducing the occurrence of AECOPD.