A Study of Heterogeneity of Chronic Obstructive Pulmonary Disease

慢性阻塞性肺疾異質性之研究

黃英漢(Ying-Han Huang) ； 王貞云(Sophie Yu Wang) ； 王正信(Jeng-Shing Wang)

《南臺灣醫學雜誌》 10卷1期 (2014/06) Pp. 1-10

https://doi.org/10.6726/MJST.201406_10(1).0001

摘要

目的：慢性阻塞性肺疾病（COPD）造成全世界顯著的發病率和死亡率。我們評估在台灣南部的肺部診療穩定的COPD患者的特點，並評估暴露於生物質燃料和粉塵作業是否與慢性阻塞性肺病患者的呼吸道症狀，氣流受限，以及生活品質相關。方法：這個橫斷面觀察性研究招募來自台灣南部的117例COPD患者。患者接受肺功能檢查，並填問卷關於他們暴露於吸煙，生物質燃料和粉塵作業，以及呼吸道症狀和健康相關生活品質。結果：患者中，暴露於生物質燃料和粉塵作業的歷史，以及咳嗽，有痰，喘息，呼吸困難的呼吸道症狀似乎有變異性。這些症狀在那些慢性阻塞性肺疾病分期（GOLD）較高的慢性阻塞性肺病患者更加頻繁（所有比較P ＜ 0.001）。生活品質在那些具有較高的慢性阻塞性肺疾病分期（GOLD）（44.3對比35.6對比27.3對比14.5 SGRQ總分，P ＜ 0.001）較差。呼吸困難在這些COPD患者，暴露於粉塵作業的歷史比沒有為更嚴重，同時暴露於生物質燃料的歷史比沒有為更嚴重（兩則P ＜ 0.05）。氣流受限在這些COPD患者，暴露於粉塵作業的歷史比沒有為更嚴重（43.6%對比50.7%支氣管擴張劑後的FEV1，P ＜ 0.05）結論：在台灣南部，慢性阻塞性肺病患者的特點各不相同，暴露於生物質燃料或粉塵作業的歷史與呼吸困難相關，而暴露在粉塵作業的歷史是與嚴重的氣流受限相關。頻繁的症狀和生活品質差均與較高的慢性阻塞性肺疾病分期相關。

關鍵字

生物質 ； 慢性阻塞性肺病 ； 粉塵 ； 南台灣

並列摘要

Objective: Chronic obstructive pulmonary disease (COPD) is responsible for significant morbidity and mortality worldwide. We evaluated the characteristics of stable COPD patients in the pulmonology clinics of southern Taiwan and also evaluated whether the exposure to biomass fuels and dusty jobs were related to respiratory symptoms, airflow limitation, and quality of life in the COPD patients. Methods: This cross-sectional observational study recruited 117 COPD patients from southern Taiwan. The patients underwent spirometry and were administered questionnaires about their exposure to cigarette smoking, biomass fuels, and dusty jobs in addition to respiratory symptoms and health related quality of life. Results: Of the patients, there appeared to be variations in the history of exposure to biomass fuels and dusty jobs and also in respiratory symptoms of cough, phlegm, wheeze, and dyspnea. These symptoms were more frequent in those COPD patients with a higher global initiative for chronic obstructive pulmonary disease (GOLD) stage (p ＜ 0.001 for all comparisons). The quality of life was poorer in those with a higher GOLD stage (44.3 vs. 35.6 vs. 27.3 vs. 14.5 of the St George’s Respiratory Questionnaire [SGRQ] total score, p ＜ 0.001). Dyspnea was more frequent in those COPD patients with a history of exposure to biomass fuels than without and those with a history of exposure to dusty jobs than without (p ＜ 0.05 for both comparisons). Airflow limitation was more severe in those COPD patients with a history of exposure to dusty jobs than without (43.6% predicted versus 50.7% of post-bronchodilator forced expiratory volume in 1 second [FEV1], P ＜ 0.05). Conclusions: In southern Taiwan, the characteristics of COPD patients vary and the history of exposure to biomass fuels or dusty jobs was related to frequency of dyspnea, while the history of exposure to dusty jobs was related to severe airflow limitation. The frequent symptoms and poor quality of life were related to higher GOLD stages.

並列關鍵字

biomass ； COPD ； dust ； southern Taiwan