Early Diagnosis And Missed Diagnosis Of Chronic Obstructive Pulmonary Disease

Objective:To analyze the effects on the early diagnosis of chronic obstructive pulmonary disease?COPD?after patients with basic lung function FEV₁%pred?70%but FEV₁/FVC<70%undergoing excitation test or diastolic test,and investigate how to detect and diagnose COPD early among these patients so as to reduce missed diagnosis.Methods:Retrospectively collected clinical data of 396 patients with basic lung function FEV₁%pred?70%but FEV₁/FVC<70%who saw a doctor in the department of respiratory medicine of the Second Hospital of Shanxi Medical University from July 1,2017 to May 31,2018.Among these patients,274 patients underwent excitation test and 122 patients underwent bronchial diastolic test.Patients in the diastolic group were divided into two groups:FEV1/FVC<70%after diastolic test?group A?,and FEV1/FVC?70%after diastolic test?Group B?.Analyzed the baseline data and lung function characteristics of the two groups,and combined with the results of lung function of some follow-up patients,analyzed the value of timing of diastolic lung function test in the early diagnosis of COPD.Results:1.Seventy-five of the 122 patients with basic lung function FEV₁%pred?70%but FEV₁/FVC<70%who underwent bronchial dilation test met the diagnostic criteria for COPD after the diastolic test.2.There were correlations between post-diastolic FEV1/FVC and age,pre-diastolic FEV1/FVC,pre-diastolic FEV1/FVC%pred,pre-diastolic MEF75%pred,pre-diastolic MEF50%pred,pre-diastolic MMEF%pred.The correlation coefficients were-0.526,0.648,0.241,0.399,0.355,0.188 respectively.But,there was no correlation between post-diastolic FEV1/FVC with pre-diastolic FEV1%pred.3.There were differences in the age and gender between the two groups,and the differences were statistically significant?P<0.05?.4.After inhalation of terbutaline sulfate in patients with A and B,the lung function indexes were improved compared with the basic lung function,and the differences were statistically significant?P<0.05?.5.Some patients in the excitation test group were reviewed again for lung function test,and FEV1/FVC<70%after the diastolic test,indicating that the cases of missed diagnosis of COPD existed.Conclusion:There were the early missed diagnosis of COPD when the patients with basic lung function FEV₁%pred?70%but FEV₁/FVC<70%underwent lung function test in the clinic.The results suggest that the male patients whose age?40,and with low level of baseline of lung function FEV1/FVC,FEV1/FVC%pred,MEF75%pred,MEF50%pred,MMEF%pred undergo a diastolic test first to improve early diagnosis and reduce early missed diagnosis of COPD.