Differences in clinical features between biomass smoke-induced COPD or cigarette smoke-induced COPD.

doi:10.7504/nk2014090401

Abstract

Abstract:

Abstract：Objective To evaluate the clinical differences between COPD due to tobacco and to biomass smoke.Methods We retrospectively studied the records of 287 patients diagnosed of COPD due to tobacco or to biomass smoke exposure.Results (1)genernal information：including sex，age and body index，et al.(2)clinical symptom：including dyspnea and other symptom.(3)COPD assessment，including lung function assessment and combinated COPD assessment.(4)Exacerbation of COPD.Result(1)There were more males in the tobacco group(83.5% vs 16.5%)，while there were more females in the tobacco group(85.2% vs 14.8%)(χ2=27.2，P<0.05).Body index values of female patients were lower in the biomass group compared with tobacco group.There was no difference of age between two groups.(2)Dyspnea index(mMRC)were similar between both groups；Wheezing was more common in biomass group compared with tobacco group(38.3% vs 11.1%)(χ2=17.9，P<0.05).There were more complication(such as allergic rhinitis and asthma)in biomass group compared with tobacco group(43.2% vs 18%)(χ2=16.1，P<0.05).There were more lung cancer in tobacco group compared with biomass group(7.77% vs 3.7%)(χ2=9.7，P<0.05).(3)COPD assessment：More patients were classified in GOLD B or D stage in the biomass group than in the tobacco group.(4)Exacerbation of COPD：Exacerbation of COPD were also similar between the biomass and tobacco groups.Conclusion There are several clinical differences between patients with COPD due to tobacco and to biomass smoke exposure.There were more females in the biomass group.Female patients in biomass group have low body mass index，more clinical symptom and more complication(such as allergic rhinitis and asthma).More patients were classified in GOLD B or D stage in the biomass group；There were more males in the tobacco group.Patients in tobacco group have more complication(such as lung cancer).

Key words: COPD, cigarette smoke, biomass smoke, clinical features

摘要：

目的观察吸烟和生物燃料所致慢性阻塞性肺疾病(COPD)患者临床特征的差异。方法回顾性分析2011年3月至2014年3月在广州呼吸疾病研究所206例由吸烟和81例生物燃料导致的慢阻肺患者的临床资料，分别比较了两组患者的一般情况、临床症状、呼吸困难评分和合并症等方面的差异；肺功能和分级及急性加重的差异。结果 (1)一般情况的差异：吸烟所致慢阻肺患者中男性和女性的比例分别为83.5%和16.5%，生物燃料所致慢阻肺的患者中男性和女性的比例分别为14.8%和85.2%(χ2=27.2，P<0.05)。吸烟所致慢阻肺患者多见于男性，而生物燃料所致慢阻肺患者多见于女性；性别矫正后，生物燃料所致的女性COPD患者的体重指数(BMI)低于吸烟所致的女性COPD患者的BMI。其他指标如年龄两组差异无统计学意义。(2)临床症状差异：生物燃料和吸烟所致慢阻肺患者的呼吸困难指数mMRC差异无统计学意义；生物燃料所致慢阻肺患者出现喘息症状多于吸烟所致慢阻肺的患者，分别为38.3%和11.1%(χ2=17.9，P<0.05)。生物燃料所致慢阻肺患者合并过敏性疾病(如过敏性鼻炎、支气管哮喘)比例高于吸烟所致慢阻肺的患者，分别为43.2%和18%(χ2=16.1，P<0.05)；而吸烟所致慢阻肺患者合并肺癌比例高于生物燃料所致慢阻肺的患者，分别为7.77%和3.7%(χ2=9.7，P<0.05)。(3)肺功能分级的差异：慢阻肺分级上，性别校正后生物燃料所致慢阻肺患者分级更多见于B级或D级，症状多。(4)急性加重的差异：生物燃料所致和吸烟所致的慢阻肺患者1年内急性加重次数无显著差异。结论吸烟和生物燃料所致的慢阻肺在临床特征上有很多差异：生物燃料所致慢阻肺患者多见于女性，BMI低，临床症状较多，合并症以过敏性鼻炎和支气管哮喘较多，慢阻肺分级多见于B级或D级。吸烟所致慢阻肺患者多见于男性，合并症以肺癌较多。

关键词: 慢性阻塞性肺疾病, 吸烟, 生物燃料, 临床特征

CLC Number:

R563

CHENG Lin-ling*，LIU Ya-ya，SU Zhu-quan，LIU Jun，CHEN Rong-chang，RAN Pi-xin.. Differences in clinical features between biomass smoke-induced COPD or cigarette smoke-induced COPD.[J]. Acta Metallurgica Sinica, DOI: 10.7504/nk2014090401.

程璘令1，刘雅雅2，苏柱泉1，刘君1，陈荣昌1，冉丕鑫1. 吸烟和生物燃料所致慢性阻塞性肺疾病患者临床特征差异研究[J]. 中国实用内科杂志, DOI: 10.7504/nk2014090401.

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