慢性阻塞性肺疾病戒烟者和目前吸烟者的临床特点

Clinical Characteristics of Ex-smokers and Current Smokers with Chronic Obstructive Pulmonary Disease

【目的】探讨慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)目前吸烟者与戒烟者的临床特点。【方法】选取2016年12月至2020年10月在湖南和广西13家医院呼吸科门诊就诊的COPD患者,收集所有患者的社会人口学资料、肺功能指标、症状评分等。采用Logistic回归分析戒烟的影响因素。【结果】本研究共纳入6609例COPD患者,平均年龄(62.3±8.9)岁,戒烟者占43.3%。与目前吸烟者相比,戒烟者年龄更大,呼吸困难程度更高,气流受限更严重,吸烟持续时间更短,累积吸烟量更低。Logistic回归分析显示:吸烟持续时间、累积吸烟量与戒烟呈负相关,年龄、文化水平、吸烟强度、改良的英国医学委员会量表(mMRC)评分、慢性阻塞性肺疾病全球倡议(Global Initiative for Chronic Obstructive Lung Disease,GOLD)分级与戒烟呈正相关。【结论】在吸烟COPD患者中,超过一半的人仍在吸烟;戒烟者与目前吸烟者临床特点存在一定的差异;年龄、文化水平、累积吸烟量、疾病严重程度、mMRC评分、GOLD分级与COPD患者戒烟相关,给戒烟者临床干预时应考虑上述戒烟的影响因素。

【Objective】To compare the clinical characteristics of current smokers and ex-smokers.【Methods】COPD patients admitted to the respiratory outpatient department of 13 hospitals in Hunan and Guangxi on December 2016 and October 2020 were selected.Information on demographic and sociological data,lung function,and modified Medical Research Council(mMRC)dyspnea scale scores were recorded.A logistic regression analysis was performed to analyze the factors associated with smoking cessation.【Results】Of the total,the mean age was(62.3±8.9)years,and 43.3% were ex-smokers.Compared with the current smokers,the ex-smokers were older,and had heavier dyspnea,more severe airflow limitation,shorter smoking duration,and fewer pack-years.The logistic regression model showed that smoking cessation was negatively correlated with years of smoking,pack-years,but was positively correlated with age,education level,amount smoked,mMRC score,and GOLD grades.【Conclusion】Among patients with COPD,more than half still smoked.Ex-smokers differed substantially from continuing smokers in clinical characteristics.Age,educational level,cumulative smoking,disease severity,mMRC score are associated with smoking cessation,and these should be taken into account in smoking-cessation interventions.