摘要
目的探讨慢性阻塞性肺疾病(COPD)2013年西班牙新指南新临床分型的临床意义。方法回顾收集2009年1月至2014年12月安徽医科大学附属安庆市立医院呼吸内科收治的确诊COPD患者640例的临床资料,按照2013年西班牙指南的分型方法将其分为A、B、C、D四组,对各组的肺功能和血气分析指标、合并症的发生率及抗生素、激素的使用量进行分析比较。结果 C组和D组的肺功能指标第一秒用力呼气容积(FEV1)、第一秒用力呼气容积/用力肺活量(FEV1%)明显低于A组和B组(P<0.05);糖尿病、高血压在各组中患病比例差异无统计学意义(P>0.05);而冠心病、心律失常、心力衰竭在C、D组比例明显高于A组和B组(P<0.05),其在D组中比例高于C组(P<0.05)。A、B组抗生素的使用时间明显低于C、D组(P<0.05),D组的抗生素使用时间显著高于C组(P<0.05)。B组激素使用量高于其他组(P<0.05),C、D组的激素使用量高于A组(P<0.05)。D组的住院时间在各组中最高,而A组的住院时间最短。D组在机械通气、机械通气时间、病死率上明显高于其他组(P<0.05)。结论新指南的临床分型有重要指导作用,需要深入研究来验证其临床价值。
Objective To investigate the clinical significance of the clinical classification of the Spanish newclinical guidelines in chronic obstructive pulmonary disease（ COPD） in 2013. Methods A total of 640 cases who had been diagnosed as COPD and hospitalized in the department of respiratory medicine of Anqing Municipal Hospital Affilicated to Anhui Medical University were collected from January 2009 to December 2014. According to the typing method of Spanish guidelines in 2013,the 640 cases were divided into four groups named A,B,C and D respectively. The pulmonary function,index of analysis of blood gas,morbidity of complication,the usage of antibiotics and hormone of each group were analyzed and compared. Results Pulmonary function forced expiratory volume in one second（ FEV1） and forced expiratory volume in one second/forced vital capacity（ FEV1%） in groups C and D were significantly lower than those in groups A and B（ P〈0. 05）. There was no significant difference in each group about the morbidity of diabetes and hypertension（ P〉0. 05）,while the incidence of coronary heart disease,arrhythmia and heart failure in groups C and D were significantly higher than those in groups A and B（ P〈0. 05）,and in group D higher than in group C（ P〈0. 05）. The usage time of antibiotics in groups A and B were significantly lower than that in groups C and D（ P〈0. 05）,and in group D was obviously higher than in group C（ P〈0. 05）. The use amount of hormone in group B was higher than that in groups A,C and D（ P〈0. 05）,and in groups C and D higher than in group A（ P〈0. 05）. In all groups,hospitalization time in group D was longest and shortest in group A. Usage of mechanicalventilation,mechanical ventilation time and mortality rate in group D was significantly higher than that in other groups（ P〈0. 05）. Conclusion The clinical classification of the newguidelines has important guiding role,but it needs further studies to verify its clinical value.
出处
《山东大学学报（医学版）》
CAS
北大核心
2016年第3期63-67,共5页
Journal of Shandong University:Health Sciences
关键词
慢性阻塞性肺疾病
西班牙新指南
临床分型
Chronic obstructive pulmonary disease
Spanish newclinical guidelines
Clinical classification
