Objective. To study the difference of interstitial lung diseases (ILDs) in high-resolution computerized tomography and pulmonary function test among different connective tissue diseases (CTDs). Methods. 209 patients w...Objective. To study the difference of interstitial lung diseases (ILDs) in high-resolution computerized tomography and pulmonary function test among different connective tissue diseases (CTDs). Methods. 209 patients with different CTDs were recruited and underwent lung HRCT and PFT. Eerythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum ferritin (SF), anti-SSA, and so on were tested. Based on HRCT, a patient was classified into ILD group (CTD+ILD) or non-ILD group (CTD-ILD). HRCT, PFT, and laboratory markers were compared according to CTDs and CTD-associated ILDs. Results. The incidences of ILD were 79.6%, 82.0%, 89.7%, and 97.1% respectively for Rheumatoid arthritis (RA), primary Sjogren’s symptom (pSS), dermatomyositis/polymyositis (DM/PM), and systemic sclerosis (SSc) groups. RA and pSS patients exhibited more nodules, patching, ground-glass opacity, and cord shadow foci in HRCT, DM/PM and SSc patients exhibited more reticular opacity and honeycombing foci. RA and pSS patients exhibited more obstructive ventilatory disorder, small airway dysfunction and emphysema in PFT, and DM/PM and SSc patients exhibited more restrictive ventilatory disorder, mixed ventilatory disorder. ESR, CRP and SF were significantly higher in total CTD+ILD group than in total CTD-ILD group (P = 0.047, 0.006, 0.004, respectively), and higher in different CTD+ ILD groups than in comparable CTD-ILD groups (P = 0.049, 0.048, and 0.023, pSS+ILD, SSc+ILD and RA+ILD compared to pSS-ILD, SSc-ILD and RA-ILD, respectively for ESR, CRP, SF). The positive rate of anti-SSA was significantly higher in DM/PM+ILD group than in DM/PM-ILD group (P = 0.025). Conclusions. The manifestations and incidences of ILDs differ among different CTDs in HRCT and PFT, and inflammation and anti-SSA are positively correlated with ILDs in different CTDs, which provide important evidences for judging disease condition and prognosis.展开更多
Objective: The aim of this preliminary study was to evaluate the feasibility of exercise testing (ET) for predicting postoperative complications in patients with impaired pulmonary function. Methods: Thirteen patients...Objective: The aim of this preliminary study was to evaluate the feasibility of exercise testing (ET) for predicting postoperative complications in patients with impaired pulmonary function. Methods: Thirteen patients were prospectively enrolled. The enrollment criteria were FEV1.0% 8 by the Goddard classification or interstitial pneumonia on chest computed tomography. Patients underwent testing for pulmonary function, six-minute walking test (6MWT), and stair-climbing test (SCT). Postoperative cardiopulmonary complications (PCPCs) were recorded. Results: Four patients developed PCPCs. There were no significant differences between the patients with PCPCs (n = 4) and those without PCPCs (n = 9) for background data and PFT. The distances achieved in the 6MWT were 503 ± 72.7 m for patients without PCPCs and 369 ± 50.7 m for patients with PCPCs (p = 0.011). The SCT climbing heights were 20.4 ± 5.3 m for patients without PCPCs and 14.9 ± 4.0 m for patients with PCPCs (P = 0.187). Cut-off points, including a 6MFT distance of less than 400 m, SCT height lower than 15 m, and SCT climbing speed less than 8.5 m/min, were predictive of CPCP. Conclusions: Exercise testing is more feasible for predicting postoperative cardiopulmonary complications than stationary pulmonary function testing.展开更多
Background: Occupational health is an important consideration, especially for people that work in an environment with pollutants. Gasoline attendants are individuals that work in filling stations. They are constantly ...Background: Occupational health is an important consideration, especially for people that work in an environment with pollutants. Gasoline attendants are individuals that work in filling stations. They are constantly exposed to gasoline fumes and automobile engine products from vehicle exhaust. This increases the risk of acute and chronic respiratory diseases and carcinogenesis among them. The risk of health complications tends to increase with the duration of exposure. The study aimed to determine the proportion of gasoline attendants with lung function impairment. Methods and Materials: Two hundred and eight eligible participants were recruited for this study. A cross-sectional analytical study was carried out in Esan West local government area of Edo state, Nigeria. The study was carried out for a period of six months from December 2015 to May 2016. A questionnaire was used to obtain information on demographic characteristics, work history, mode of exposure and duration of exposure to petrol fumes. Lung function was assessed using a DTspiro spirometer (Model POP 10. Serial no 110843-005);also the anthropometric parameters of the respondent were measured. Statistical analysis was done using IBM SPSS version 20.0. Frequency and percentages were used to present categorical data. The mean and standard deviation of continuous variables were calculated and compared using the student’s t-test. The criteria of significant association were assumed for a p-value less than 0.05. Results: A total of one hundred and forty petrol pump attendants and one hundred and forty controls participated in this study. The mean age for petrol pump attendants was 24 ± 3.1 years and 23 ± 2.8 years for the control group. There were no significant differences in the gender distribution and anthropometric parameters as observed in this study. The lung impairment pattern observed in this study was obstructive in twelve (8.6%) gasoline pump attendants and restrictive pattern in thirty-nine (27.9%) gasoline pump attendants, while only four (2.9%) had an obstructive pattern and twelve (8.6%) had a restrictive pattern of lung impairment among the control group. This implies that a restrictive pattern was predominant. This study also observed that there was an increase in the number of gasoline pump attendants with declined lung function compared to the control group. Conclusion: Restrictive pattern of lung impairment was more predominant than the obstructive pattern among gasoline pump attendants. As a result, public health interventions should be instituted among these individuals, especially in developing countries.展开更多
Background: Occupational health is an important consideration, especially for people that work in an environment with pollutants. Gasoline attendants are individuals that work in filling stations. They are constantly ...Background: Occupational health is an important consideration, especially for people that work in an environment with pollutants. Gasoline attendants are individuals that work in filling stations. They are constantly exposed to gasoline fumes and automobile engine products from vehicle exhaust. This increases the risk of acute and chronic respiratory diseases and carcinogenesis among them. The risk of health complications tends to increase with the duration of exposure. The study aimed to determine the proportion of gasoline attendants with lung function impairment. Methods and Materials: Two hundred and eight eligible participants were recruited for this study. A cross-sectional analytical study was carried out in Esan West local government area of Edo state, Nigeria. The study was carried out for a period of six months from December 2015 to May 2016. A questionnaire was used to obtain information on demographic characteristics, work history, mode of exposure and duration of exposure to petrol fumes. Lung function was assessed using a DTspiro spirometer (Model POP 10. Serial no 110843-005);also the anthropometric parameters of the respondent were measured. Statistical analysis was done using IBM SPSS version 20.0. Frequency and percentages were used to present categorical data. The mean and standard deviation of continuous variables were calculated and compared using the student’s t-test. The criteria of significant association were assumed for a p-value less than 0.05. Results: A total of one hundred and forty petrol pump attendants and one hundred and forty controls participated in this study. The mean age for petrol pump attendants was 24 ± 3.1 years and 23 ± 2.8 years for the control group. There were no significant differences in the gender distribution and anthropometric parameters as observed in this study. The lung impairment pattern observed in this study was obstructive in twelve (8.6%) gasoline pump attendants and restrictive pattern in thirty-nine (27.9%) gasoline pump attendants, while only four (2.9%) had an obstructive pattern and twelve (8.6%) had a restrictive pattern of lung impairment among the control group. This implies that a restrictive pattern was predominant. This study also observed that there was an increase in the number of gasoline pump attendants with declined lung function compared to the control group. Conclusion: Restrictive pattern of lung impairment was more predominant than the obstructive pattern among gasoline pump attendants. As a result, public health interventions should be instituted among these individuals, especially in developing countries.展开更多
Background: Chronic obstructive pulmonary disease (COPD) and presence of endobronchial premalignant lesions (EPL) are individual risk factors for lung cancer (LC). However, effect of impaired lung function (ILF) on th...Background: Chronic obstructive pulmonary disease (COPD) and presence of endobronchial premalignant lesions (EPL) are individual risk factors for lung cancer (LC). However, effect of impaired lung function (ILF) on the natural history of EPL has not been explored. Patients and Methods: This study included 217 high-risk participants from a hospital-based LC surveillance cohort who underwent pulmonary function testing followed by bronchoscopy with endobronchial biopsies. Baseline histopathology diagnoses included 91 cases (41.9%) with squamous metaplasia (SM), 25 (11.5%) with squamous dysplasia (SD), 1 (0.5%) with in-situ carcinoma and 5 (2.3%) with invasive LC. Follow-up biopsies were obtained for 69 patients, and 16 (23.2%) patients demonstrated progression to a higher grade lesion. Regression models were used to evaluate the relationship between ILF and EPL. All the models were adjusted for age, gender and tobacco smoking. Results: Patients with FEV1% of <50% had 4.5 times greater risk of being diagnosed with an EPL [95% confidence interval: 1.93-10.80] and 8-fold greater risk of SD, compared to patients with FEV1% ≥80. COPD was associated with 2.7 and 4.8 times greater risk of SM and SD, respectively. The mean time to progression to a higher-grade lesion was shorter in COPD patients compared to patients without COPD (27 versus 50 months, p = 0.02). Conclusion: Our results indicate that ILF may be a predictor of prevalence and progression of EPLs among patients at high risk of LC. Therefore, spirometry can be a complementary pre-screening tool for identifying patients with EPL who need more intense LC surveillance.展开更多
[目的]观察补肺益肾方对肺肾气虚型慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期患者肺康复的作用。[方法]搜集2021年10月至2023年1月浙江医院确诊的肺肾气虚型COPD稳定期患者55例,随机分成试验组(26例)和对照...[目的]观察补肺益肾方对肺肾气虚型慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期患者肺康复的作用。[方法]搜集2021年10月至2023年1月浙江医院确诊的肺肾气虚型COPD稳定期患者55例,随机分成试验组(26例)和对照组(29例)。对照组予稳定期吸入剂+肺康复运动训练治疗方案,试验组在此基础上予补肺益肾方加减治疗。评估两组患者治疗前,治疗第4周、第8周的肺功能指标第1秒用力呼气容积(forced expiratory volume in the first second,FEV1)、第1秒用力呼气容积占预计值百分比(forced expiratory volume in the first second to predicted values,FEV1%)、第一秒用力呼气容积占用力肺活量比值(forced expiratory volume in one second to forced vital capacity,FEV1/FVC)、慢性阻塞性肺疾病评估测试(chronic obstructive pulmonary disease assessment test,CAT)评分、咳嗽能力评分、咳痰难度评分、体质量指数(body mass index,BMI),并监测患者不良反应情况。[结果]与本组治疗前比较,两组在治疗4周、8周,FEV1、FEV1%均有升高,CAT评分、咳嗽难度均有下降,差异均有统计学意义(P<0.05);BMI、咳嗽能力差异无统计学意义(P>0.05);试验组FEV1/FVC治疗4周差异无统计学意义(P>0.05),治疗8周升高,差异有统计学意义(P<0.05)。与对照组同期比较,试验组在治疗4周、8周,CAT评分降低、咳嗽难度下降,差异均有统计学意义(P<0.05),FEV1、FEV1%、咳嗽能力、BMI差异均无统计学意义(P>0.05);试验组FEV1/FVC在治疗4周差异无统计学意义(P>0.05),治疗8周升高,差异有统计学意义(P<0.05)。[结论]补肺益肾方在COPD稳定期患者中对肺康复起到协同作用。展开更多
背景与目的肺癌是慢性阻塞性肺疾病(慢阻肺)重要的合并症,会显著影响慢阻肺患者的预后。慢阻肺也会影响肺癌患者的术后并发症和复发。本研究旨在调查胸外科住院肺癌合并慢阻肺的情况。方法回顾性分析北京大学人民医院胸外科2015年1月-2...背景与目的肺癌是慢性阻塞性肺疾病(慢阻肺)重要的合并症,会显著影响慢阻肺患者的预后。慢阻肺也会影响肺癌患者的术后并发症和复发。本研究旨在调查胸外科住院肺癌合并慢阻肺的情况。方法回顾性分析北京大学人民医院胸外科2015年1月-2015年12月收治的原发性非小细胞肺癌患者。通过查阅病历获取患者的性别、年龄、吸烟状况、有害职业史、症状、胸部计算机断层扫描(computed tomography,CT)、术后病理、出院诊断、全套肺功能及支气管舒张试验,当基础肺功能第一秒钟用力呼气容积(forced expiratory volume in one second,FEV_1)占预计值<70%时即行支气管舒张试验。结果 703例肺癌患者进行了全套肺功能测定,其中67例进行支气管舒张试验,62例(92.5%)符合慢阻肺诊断。接受手术治疗的肺癌患者有677例,其中41例进行支气管舒张试验,38例(92.7%)符合慢阻肺诊断。在接受手术治疗的肺癌患者中合并慢阻肺者年龄≥65岁、男性、有吸烟史和非腺癌的比例高于未合并慢阻肺者,差异有统计学意义(P<0.05);男性和≥65岁者更易合并慢阻肺(OR:2.807-2.374,95%CI:1.101-7.157)(P<0.05)。住院前仅有3例(4.3‰)诊断慢阻肺并按慢阻肺规范治疗。出院时仅有5例(7.1‰)诊断慢阻肺。结论在胸外科住院肺癌患者中行常规肺功能及支气管舒张试验可提高肺癌合并慢阻肺的诊断;当前肺癌合并慢阻肺诊断和治疗严重不足,需要引起胸外科医生重视,与呼吸内科医生携手共同防治慢阻肺。展开更多
文摘Objective. To study the difference of interstitial lung diseases (ILDs) in high-resolution computerized tomography and pulmonary function test among different connective tissue diseases (CTDs). Methods. 209 patients with different CTDs were recruited and underwent lung HRCT and PFT. Eerythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum ferritin (SF), anti-SSA, and so on were tested. Based on HRCT, a patient was classified into ILD group (CTD+ILD) or non-ILD group (CTD-ILD). HRCT, PFT, and laboratory markers were compared according to CTDs and CTD-associated ILDs. Results. The incidences of ILD were 79.6%, 82.0%, 89.7%, and 97.1% respectively for Rheumatoid arthritis (RA), primary Sjogren’s symptom (pSS), dermatomyositis/polymyositis (DM/PM), and systemic sclerosis (SSc) groups. RA and pSS patients exhibited more nodules, patching, ground-glass opacity, and cord shadow foci in HRCT, DM/PM and SSc patients exhibited more reticular opacity and honeycombing foci. RA and pSS patients exhibited more obstructive ventilatory disorder, small airway dysfunction and emphysema in PFT, and DM/PM and SSc patients exhibited more restrictive ventilatory disorder, mixed ventilatory disorder. ESR, CRP and SF were significantly higher in total CTD+ILD group than in total CTD-ILD group (P = 0.047, 0.006, 0.004, respectively), and higher in different CTD+ ILD groups than in comparable CTD-ILD groups (P = 0.049, 0.048, and 0.023, pSS+ILD, SSc+ILD and RA+ILD compared to pSS-ILD, SSc-ILD and RA-ILD, respectively for ESR, CRP, SF). The positive rate of anti-SSA was significantly higher in DM/PM+ILD group than in DM/PM-ILD group (P = 0.025). Conclusions. The manifestations and incidences of ILDs differ among different CTDs in HRCT and PFT, and inflammation and anti-SSA are positively correlated with ILDs in different CTDs, which provide important evidences for judging disease condition and prognosis.
文摘Objective: The aim of this preliminary study was to evaluate the feasibility of exercise testing (ET) for predicting postoperative complications in patients with impaired pulmonary function. Methods: Thirteen patients were prospectively enrolled. The enrollment criteria were FEV1.0% 8 by the Goddard classification or interstitial pneumonia on chest computed tomography. Patients underwent testing for pulmonary function, six-minute walking test (6MWT), and stair-climbing test (SCT). Postoperative cardiopulmonary complications (PCPCs) were recorded. Results: Four patients developed PCPCs. There were no significant differences between the patients with PCPCs (n = 4) and those without PCPCs (n = 9) for background data and PFT. The distances achieved in the 6MWT were 503 ± 72.7 m for patients without PCPCs and 369 ± 50.7 m for patients with PCPCs (p = 0.011). The SCT climbing heights were 20.4 ± 5.3 m for patients without PCPCs and 14.9 ± 4.0 m for patients with PCPCs (P = 0.187). Cut-off points, including a 6MFT distance of less than 400 m, SCT height lower than 15 m, and SCT climbing speed less than 8.5 m/min, were predictive of CPCP. Conclusions: Exercise testing is more feasible for predicting postoperative cardiopulmonary complications than stationary pulmonary function testing.
文摘Background: Occupational health is an important consideration, especially for people that work in an environment with pollutants. Gasoline attendants are individuals that work in filling stations. They are constantly exposed to gasoline fumes and automobile engine products from vehicle exhaust. This increases the risk of acute and chronic respiratory diseases and carcinogenesis among them. The risk of health complications tends to increase with the duration of exposure. The study aimed to determine the proportion of gasoline attendants with lung function impairment. Methods and Materials: Two hundred and eight eligible participants were recruited for this study. A cross-sectional analytical study was carried out in Esan West local government area of Edo state, Nigeria. The study was carried out for a period of six months from December 2015 to May 2016. A questionnaire was used to obtain information on demographic characteristics, work history, mode of exposure and duration of exposure to petrol fumes. Lung function was assessed using a DTspiro spirometer (Model POP 10. Serial no 110843-005);also the anthropometric parameters of the respondent were measured. Statistical analysis was done using IBM SPSS version 20.0. Frequency and percentages were used to present categorical data. The mean and standard deviation of continuous variables were calculated and compared using the student’s t-test. The criteria of significant association were assumed for a p-value less than 0.05. Results: A total of one hundred and forty petrol pump attendants and one hundred and forty controls participated in this study. The mean age for petrol pump attendants was 24 ± 3.1 years and 23 ± 2.8 years for the control group. There were no significant differences in the gender distribution and anthropometric parameters as observed in this study. The lung impairment pattern observed in this study was obstructive in twelve (8.6%) gasoline pump attendants and restrictive pattern in thirty-nine (27.9%) gasoline pump attendants, while only four (2.9%) had an obstructive pattern and twelve (8.6%) had a restrictive pattern of lung impairment among the control group. This implies that a restrictive pattern was predominant. This study also observed that there was an increase in the number of gasoline pump attendants with declined lung function compared to the control group. Conclusion: Restrictive pattern of lung impairment was more predominant than the obstructive pattern among gasoline pump attendants. As a result, public health interventions should be instituted among these individuals, especially in developing countries.
文摘Background: Occupational health is an important consideration, especially for people that work in an environment with pollutants. Gasoline attendants are individuals that work in filling stations. They are constantly exposed to gasoline fumes and automobile engine products from vehicle exhaust. This increases the risk of acute and chronic respiratory diseases and carcinogenesis among them. The risk of health complications tends to increase with the duration of exposure. The study aimed to determine the proportion of gasoline attendants with lung function impairment. Methods and Materials: Two hundred and eight eligible participants were recruited for this study. A cross-sectional analytical study was carried out in Esan West local government area of Edo state, Nigeria. The study was carried out for a period of six months from December 2015 to May 2016. A questionnaire was used to obtain information on demographic characteristics, work history, mode of exposure and duration of exposure to petrol fumes. Lung function was assessed using a DTspiro spirometer (Model POP 10. Serial no 110843-005);also the anthropometric parameters of the respondent were measured. Statistical analysis was done using IBM SPSS version 20.0. Frequency and percentages were used to present categorical data. The mean and standard deviation of continuous variables were calculated and compared using the student’s t-test. The criteria of significant association were assumed for a p-value less than 0.05. Results: A total of one hundred and forty petrol pump attendants and one hundred and forty controls participated in this study. The mean age for petrol pump attendants was 24 ± 3.1 years and 23 ± 2.8 years for the control group. There were no significant differences in the gender distribution and anthropometric parameters as observed in this study. The lung impairment pattern observed in this study was obstructive in twelve (8.6%) gasoline pump attendants and restrictive pattern in thirty-nine (27.9%) gasoline pump attendants, while only four (2.9%) had an obstructive pattern and twelve (8.6%) had a restrictive pattern of lung impairment among the control group. This implies that a restrictive pattern was predominant. This study also observed that there was an increase in the number of gasoline pump attendants with declined lung function compared to the control group. Conclusion: Restrictive pattern of lung impairment was more predominant than the obstructive pattern among gasoline pump attendants. As a result, public health interventions should be instituted among these individuals, especially in developing countries.
文摘Background: Chronic obstructive pulmonary disease (COPD) and presence of endobronchial premalignant lesions (EPL) are individual risk factors for lung cancer (LC). However, effect of impaired lung function (ILF) on the natural history of EPL has not been explored. Patients and Methods: This study included 217 high-risk participants from a hospital-based LC surveillance cohort who underwent pulmonary function testing followed by bronchoscopy with endobronchial biopsies. Baseline histopathology diagnoses included 91 cases (41.9%) with squamous metaplasia (SM), 25 (11.5%) with squamous dysplasia (SD), 1 (0.5%) with in-situ carcinoma and 5 (2.3%) with invasive LC. Follow-up biopsies were obtained for 69 patients, and 16 (23.2%) patients demonstrated progression to a higher grade lesion. Regression models were used to evaluate the relationship between ILF and EPL. All the models were adjusted for age, gender and tobacco smoking. Results: Patients with FEV1% of <50% had 4.5 times greater risk of being diagnosed with an EPL [95% confidence interval: 1.93-10.80] and 8-fold greater risk of SD, compared to patients with FEV1% ≥80. COPD was associated with 2.7 and 4.8 times greater risk of SM and SD, respectively. The mean time to progression to a higher-grade lesion was shorter in COPD patients compared to patients without COPD (27 versus 50 months, p = 0.02). Conclusion: Our results indicate that ILF may be a predictor of prevalence and progression of EPLs among patients at high risk of LC. Therefore, spirometry can be a complementary pre-screening tool for identifying patients with EPL who need more intense LC surveillance.
文摘[目的]观察补肺益肾方对肺肾气虚型慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期患者肺康复的作用。[方法]搜集2021年10月至2023年1月浙江医院确诊的肺肾气虚型COPD稳定期患者55例,随机分成试验组(26例)和对照组(29例)。对照组予稳定期吸入剂+肺康复运动训练治疗方案,试验组在此基础上予补肺益肾方加减治疗。评估两组患者治疗前,治疗第4周、第8周的肺功能指标第1秒用力呼气容积(forced expiratory volume in the first second,FEV1)、第1秒用力呼气容积占预计值百分比(forced expiratory volume in the first second to predicted values,FEV1%)、第一秒用力呼气容积占用力肺活量比值(forced expiratory volume in one second to forced vital capacity,FEV1/FVC)、慢性阻塞性肺疾病评估测试(chronic obstructive pulmonary disease assessment test,CAT)评分、咳嗽能力评分、咳痰难度评分、体质量指数(body mass index,BMI),并监测患者不良反应情况。[结果]与本组治疗前比较,两组在治疗4周、8周,FEV1、FEV1%均有升高,CAT评分、咳嗽难度均有下降,差异均有统计学意义(P<0.05);BMI、咳嗽能力差异无统计学意义(P>0.05);试验组FEV1/FVC治疗4周差异无统计学意义(P>0.05),治疗8周升高,差异有统计学意义(P<0.05)。与对照组同期比较,试验组在治疗4周、8周,CAT评分降低、咳嗽难度下降,差异均有统计学意义(P<0.05),FEV1、FEV1%、咳嗽能力、BMI差异均无统计学意义(P>0.05);试验组FEV1/FVC在治疗4周差异无统计学意义(P>0.05),治疗8周升高,差异有统计学意义(P<0.05)。[结论]补肺益肾方在COPD稳定期患者中对肺康复起到协同作用。
文摘背景与目的肺癌是慢性阻塞性肺疾病(慢阻肺)重要的合并症,会显著影响慢阻肺患者的预后。慢阻肺也会影响肺癌患者的术后并发症和复发。本研究旨在调查胸外科住院肺癌合并慢阻肺的情况。方法回顾性分析北京大学人民医院胸外科2015年1月-2015年12月收治的原发性非小细胞肺癌患者。通过查阅病历获取患者的性别、年龄、吸烟状况、有害职业史、症状、胸部计算机断层扫描(computed tomography,CT)、术后病理、出院诊断、全套肺功能及支气管舒张试验,当基础肺功能第一秒钟用力呼气容积(forced expiratory volume in one second,FEV_1)占预计值<70%时即行支气管舒张试验。结果 703例肺癌患者进行了全套肺功能测定,其中67例进行支气管舒张试验,62例(92.5%)符合慢阻肺诊断。接受手术治疗的肺癌患者有677例,其中41例进行支气管舒张试验,38例(92.7%)符合慢阻肺诊断。在接受手术治疗的肺癌患者中合并慢阻肺者年龄≥65岁、男性、有吸烟史和非腺癌的比例高于未合并慢阻肺者,差异有统计学意义(P<0.05);男性和≥65岁者更易合并慢阻肺(OR:2.807-2.374,95%CI:1.101-7.157)(P<0.05)。住院前仅有3例(4.3‰)诊断慢阻肺并按慢阻肺规范治疗。出院时仅有5例(7.1‰)诊断慢阻肺。结论在胸外科住院肺癌患者中行常规肺功能及支气管舒张试验可提高肺癌合并慢阻肺的诊断;当前肺癌合并慢阻肺诊断和治疗严重不足,需要引起胸外科医生重视,与呼吸内科医生携手共同防治慢阻肺。
