摘要
目的探讨不同风险慢性阻塞性肺疾病(COPD)患者戒烟干预对其临床症状及肺功能的影响,为不同风险的吸烟COPD患者的防治提供依据。方法将我院稳定期吸烟COPD患者109例随机分为戒烟干预组和对照组,按肺功能分级及入组前1年急性加重次数分别将戒烟干预组、对照组分为戒烟干预低风险组(30例)、戒烟干预高风险组(25例)和对照低风险组(33例)、对照高风险组(21例)4个亚组,对4组患者进行为期1年的追踪随访,戒烟干预组在常规治疗基础上进行戒烟干预,对照组给予常规治疗,比较患者入组时、1年后临床症状评分和1 s用力呼气容积(FEV1)。结果随访满1年时,戒烟干预低风险组症状评分变化量为(2.23±0.86)分,对照低风险组为(1.39±0.70)分,戒烟干预低风险组临床症状的改善优于对照低风险组,差异有统计学意义(P<0.001);戒烟干预低风险组FEV1变化量为(0.060±0.429)L,对照低风险组为(0.335±0.406)L,对照低风险组FEV1的下降高于戒烟干预低风险组,差异有统计学意义(P=0.011)。戒烟干预高风险组症状评分变化量为(2.72±0.89)分,对照高风险组为(1.86±0.65)分,戒烟干预高风险组临床症状的改善优于对照高风险组,差异有统计学意义(P=0.001);戒烟干预高风险组FEV1变化量为(0.012±0.138)L,对照高风险组为(0.127±0.144)L,对照高风险组FEV1的下降高于戒烟干预高风险组,差异有统计学意义(P=0.008)。结论戒烟干预可以明显改善吸烟COPD患者的临床症状、延缓其FEV1下降,随访及戒烟干预对吸烟的高风险COPD患者改善临床症状、降低急性加重风险更具有临床意义。
Objective To study the effect of smoking cessation on clinical manifestations and lung function of chronic obstructive pulmonary disease （COPD） patients at different levels of risk of progression. Methods A total of 109 smoking COPD patients at different levels of risk of progression to acute exacerbation were randomly divided into a control group and a smoking cessation intervention group. According to the recorded lung function test results and the frequency of acute exacerbation one prior to the study, patients in each of the two groups were further divided into two sub - groups： low progression risk and high progression risk. Patients in the control group underwent conventional treatment and those in the intervention group underwent smoking cessation intervention. Both at the beginning and at the end of one year post - treatment follow - up, clinical symptoms were scored and lung function test and forced expiratory volume in 1 second （FEY I） measurement were performed. Results At the end of one year post - treatment follow - up, the clinical symptom score was （2. 23 ± 0. 86） in the low - risk intervention group （ n = 30） and （1. 39 ± 0. 70） in the low - risk control group （n = 33） . The degree of the symptom score improvement was greater in the low - risk intervention group and in the＇ low - risk control group （P 〈 0. 001） . The FEY I was （0. 060 ± 0. 429） L in the low - risk intervention group and （0. 335 ± O. 406） L in the low - risk control group. The decrease in the FEY I was more pronounced in the low - risk control group than in the low - risk intervention group （P = 0. 011） . The clinical symptom score was （2.72 ± 0. 89） in the high - risk intervention group （n = 25） and （ 1. 86 ± 0. 65） in the high - risk control group （n = 21） . The degree of the symptom score improvement was greater in the high - risk intervention group and in the low - risk control group （P = 0. 001） . The FEV I was （0. 012 ± 0. 138） L in the high - risk intervention group and （0. 127 ± 0. 144） L in the high - risk control group. The decrease in the FEV I was more pronounced in the high - risk control group than in the high - risk intervention group （P = 0. 008） . Conclusion Interventional smoking cessation measures may can improve clinical symptoms and slow down lung function deterioration in smoking COPD patients. These effects are more significant in COPD patients at high - risk of acute exacerbation progression.
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第1期50-52,共3页
Chinese General Practice
基金
中华医学会临床医学慢性呼吸道疾病科研专项资金(07010260034)
关键词
肺疾病
慢性阻塞性
戒烟
肺功能
Pulmonary disease, chronic obstructive
Smoking cessation
Lung function
