在初级保健环境中诊断和不足诊断的COPD病例:差异和相似之处
Ioanna Filippou1, Dionisios Spyratos1, Ioanna Tsiouprou1
1Pulmonary Department, G. Papanikolaou Hospital, Aristotle University of Thessaloniki, Exohi, Thessaloniki, Greece.
Journal of family medicine and primary care
|October 3, 2025
概括
慢性阻塞性肺病 (COPD) 的错误诊断很常见,在希腊北部发现了许多未被确诊的病例. 未被确诊的COPD患者是早期疾病的年轻吸烟者,这凸显了有针对性的查和改进初级保健诊断的需要.
科学领域:
- 肺部病理学 肺部病理学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 慢性阻塞性肺病 (COPD) 构成了严重且日益增长的医疗保健负担.
- 持续的烟草使用和错误诊断有助于COPD的流行率和影响的增加.
- 错误诊断,包括过度诊断和不足诊断,使COPD管理和流行病学评估复杂化.
研究的目的:
- 评估希腊北部人口中COPD误诊 (过度和不足诊断) 的流行情况.
- 将正确诊断的COPD患者的特征与被诊断不足的患者进行比较.
- 为了确定COPD患者与没有先前正确诊断之间的差异和相似之处.
主要方法:
- 在希腊塞萨洛尼基的四个农村县和一个城市初级卫生中心进行了观察性横截面研究.
- 总共有5,239名参与者,包括吸烟者和前吸烟者.
- 诊断COPD是基于GOLD指导方针,包括临床和螺旋测量标准.
主要成果:
- 10.8% (565/5,239) 的参与者符合COPD标准.
- 诊断不足影响了301名患者,而264名患者的诊断是正确的,461名患者被过度诊断.
- 未确诊的COPD患者年轻,经常吸烟,报告的并发症较少,通常患有早期疾病,尽管个体呼吸系统症状的频率相似.
结论:
- 在被研究的人群中,大量的COPD病例被诊断不足或过度诊断.
- 未确诊的COPD的特点是年龄较小,目前吸烟,疾病早期阶段.
- 未来的战略应包括对高风险人群进行国家查,并为全科医生 (GPs) 提供精神测量和COPD管理方面的加强培训.
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