对老年慢性阻塞性肺疾病诊断的新认识

目的探讨与老年慢性阻塞性肺疾病（COPD）相关的临床特征。方法通过对265名病情稳定并能够配合的老年患者进行肺功能检查，将肺功能符合COPD诊断及无COPD的分为两组进行对比分析，并将轻度与中重度的临床特征进行对比分析。结果吸烟史、慢性咳痰喘、慢性支气管炎的诊断、慢性呼吸道疾病治疗史及急性呼吸道感染史均为COPD的常见临床特征，其发生率均高于非COPD组，两组对比有统计学差异；胸部异常X线检查、其他慢性心肺疾病两组的无统计学差异；肺部异常体征两组的差异较小。而中重度COPD除其他慢性心肺疾病外，所有临床特征发生率均高于轻度COPD患者。结论老年COPD患者胸部X线检查大多数不正常，通过临床特征有助于诊断中重度COPD。

Understanding of diagnosis of chronic obstructive pulmonary disease in aged patients

Objective To explore relevant clinical features of chronic obstructive pulmonary disease in aged patients. Methods 265 aged patients were divided into two groups ： COPD group （ according to pulmonary function ） and control group. Those with COPD were further divided into two groups： mild group and moderate or severe group. Clinical features of both groups were investigated. Results Common clinical features of COPD included history of smoking, chronic cough or gasp, history of chronic bronchitis, and his- tory of treatment of chronic respiratory tract disorder and acute respiratory tract infection. Their incidence is significantly higher in COPD group than that in control group. No statistical differences were found between the two groups with regard to the incidence of ab- normal X-ray chest examination and other heart and lung diseases. The incidence of all the clinical features in moderate or severe group was higher than in mild group, except for other heart and lung diseases. Conclusion Abnormal X-ray chest examination and other heart and lung diseases in elderly patients should not be considered as the primary clinical manifestations of COPD, but clinical features contribute to the diagnosis of patients with moderate or severe COPD.