摘要
目的了解上海市部分社区慢性阻塞性肺疾病(COPD)患者药物使用情况及与规范要求的差距,提高社区全科医师对COPD规范诊疗的意识。方法参考2011年COPD诊疗规范制定呼吸疾病问卷调查表,根据一般情况、临床表现或肺功能检查及相关治疗情况对上海市部分社区门诊患者进行问卷调查。结果共调查3 968例患者,行肺功能检查明确不完全可逆气流受限确诊为COPD的患者1 024例(占25.8%),男814例(占79.5%),女210例(占20.5%),吸烟者692例(占67.6%)。给予药物治疗者892例(占87.1%),其中β2-受体激动剂372例(占41.7%),抗胆碱能药物346例(占38.8%),糖皮质激素或混合制剂88例(占9.9%),其他药物86例(占9.6%);吸入给药150例(占16.8%),口服给药696例(占78.0%),静脉给药46例(占5.2%)。Ⅰ～Ⅳ级COPD患者药物治疗类型及用药途径差异均有统计学意义(P<0.05),Ⅰ级、Ⅱ级和Ⅲ级COPD患者中,以β2-受体激动剂、抗胆碱能药物口服治疗为主;Ⅳ级COPD患者中,以糖皮质激素或混合制剂吸入为主。结论目前社区COPD患者的药物治疗情况与诊疗规范要求存在一定差距,因此开展社区全科医师对COPD诊疗规范的学习并正确干预患者用药及制度化管理尤其重要。
Objective To explore the current status of drug use among patients with chronic obstructive pulmonary dis- ease （COPD） in the community. Methods A respiratory disease questionnaire was made based on the 2011 COPD guideline. The outpatients of some communities in Shanghai were surveyed with the questionnaire on general information, clinical manifesta- tion, pulmonary function examination, and other relevant data. Results A total of 1 024 out of 3 968 patients were diagnosed as COPD based on incomplete airflow limitation from pulmonary function examination, including 814 males （79. 5% ） and 210 fe- males （20. 5% ）. Among them, 692 cases （67.6%） were smokers; 892 cases （87. 1% ） were treated with drugs, including 372 cases treated with β2 -agonists （41.7%）, 346 cases （38.8%） with anticholinergic drugs, 88 （9. 9% ） with glueocorti- coids or mixture preparation, 86 （9.6%） with other drugs. Administration routes included inhalation （ 150, 16. 8% ）, oral （696, 78. 0% ） and intravenous administration （46, 5.2% ）. Stage I - IV COPD patients differed significantly in types of medication and administration routes （ P 〈 0. 05 ）. Oral administration of β2 - agonists and anticholinergic drugs was common a- mong stageⅠ-Ⅲ COPD patients, while inhalation of glucocorticoids or mixture preparation was common among stage Ⅳ COPD patients. Conclusion There is still a gap between the drug use in clinical practice and the 2011 guideline in the treatment of COPD. Therefore, COPD guideline learning is essential for GPs to carry out effective interventions and management in the treat- ment of COPD.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第13期1530-1532,共3页
Chinese General Practice
关键词
肺疾病
慢性阻塞性
社区干预
药物治疗
全科医生
Pulmonary disease, chronic obstructive
Community intervention
Drug treatment
General practitioners
