腱板断裂患者における喫煙状況と肺機能  [in Japanese] Smoking Status and a Pulmonary Function Test in Patients with Rotator Cuff Tears  [in Japanese]

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Author(s)

    • 吉井 千春 YOSHII Chiharu
    • 産業医科大学若松病院 呼吸器内科 Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan
    • 内田 宗志 UCHIDA Soushi
    • 産業医科大学若松病院 整形外科 Department of Orthopedic Surgery, Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan
    • 野口 真吾 NOGUCHI Shingo
    • 産業医科大学若松病院 呼吸器内科 Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan
    • 鳥井 亮 TORII Ryo
    • 産業医科大学若松病院 呼吸器内科 Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan
    • 島袋 活子 SHIMABUKURO Ikuko
    • 産業医科大学若松病院 呼吸器内科 Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan
    • 矢寺 和博 YATERA Kazuhiro
    • 産業医科大学 医学部 呼吸器内科学教室 Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan

Abstract

<p>慢性閉塞性肺疾患(chronic obstructive pulmonary disease: COPD)は喫煙者の数人に1人が罹患する疾患であるが,推計患者数に比較して極めて少ない患者しか診断されていないことが問題になっている.一方,腱板断裂の発症に喫煙が関連する報告が散見されるようになった.今回我々は腱板断裂患者における喫煙状況を調査し,さらに肺機能検査より未診断のCOPD患者の把握の可能性について検討した.対象は2011年4月から2015年6月まで当院整形外科にて腱板断裂と診断され,術前肺機能検査が行われた40歳以上の連続症例150名.性別は男性が96名,女性は54名,喫煙状況は非喫煙者が59名(39.3%),前喫煙者が62名(41.3%),喫煙者は29名(19.3%)で,喫煙率は日本人全体とほぼ同様であったが,喫煙歴のある患者では1日喫煙本数21本以上が31.9%と,日本人全体の21本以上(男性15.2%,女性5.5%)に比較して多かった.気流閉塞は150名中25名(16.7%)に認め,内訳はCOPD 7名,気管支喘息3名,気管支拡張症1名,未診断14名であった.未診断の気流閉塞は,非喫煙者が7名,前喫煙者が5名,喫煙者が2名で,COPDの病期分類Ⅰ期相当が11名, Ⅱ期相当が3名で,Ⅲ期以上はいなかった.また年代別の気流閉塞は,40代(0%),50代(8.3%),60代(20.7%),70代以上(25.6%)と,年齢が高くなるほど増加した.今回の結果から,腱板断裂患者においては,喫煙歴の有無のみならず,喫煙本数にも留意する必要性を認識できた.また術前肺機能検査のデータを共有することにより,COPDの早期発見の可能性が示唆された.</p>

<p>Although chronic obstructive pulmonary disease (COPD) affects one in several smokers, only a few patients are correctly diagnosed compared to the estimated number of patients. Several recent reports indicate that the development of rotator cuff tears is related to smoking. In this study, we investigated smoking status in patients with rotator cuff tears and evaluated the possibility of undiagnosed COPD by a pulmonary function test. The subjects were 150 consecutive patients over 40 years old, who had been diagnosed with rotator cuff tears and had been examined by a pulmonary function test before surgery in our orthopedic department between April 2011 and June 2015. They consisted of 96 men and 54 women, which included 59 non-smokers (39.3%), 62 ex-smokers (41.3%), and 29 smokers (19.3%). The smoking rate of the subjects was the same as that of the general Japanese population. However, the ever-smokers who smoked more than 21 cigarettes per day were 31.9%, which was high compared to the Japanese ever-smokers population, i.e. 15.2% of men and 5.5% of women. Twenty-five subjects (16.7%) showed airflow limitation, and they consisted of 7 cases of COPD, 3 cases of bronchial asthma, one case of bronchiectasis, and 14 undiagnosed cases. The undiagnosed cases consisted of 7 non-smokers, 5 ex-smokers, and 2 smokers. Their stages of COPD were stage 1 in 11 cases and stage 2 in 3 cases. The prevalence of airflow limitation increased with increasing age: 0% for 40's, 8.3% for 50's, 20.7% for 60's, and 25.6% for over 70's. From these results, we recognized that paying attention to the numbers of cigarettes smoked per day are important in addition to the smoking history, for the patients with rotator cuff tears. Also, sharing the data of a pulmonary function test before surgery can contribute to the early diagnosis of COPD.</p>

Journal

  • Journal of UOEH

    Journal of UOEH 38(3), 243-249, 2016

    The University of Occupational and Environmental Health, Japan

Codes

  • NII Article ID (NAID)
    130005410835
  • Text Lang
    JPN
  • ISSN
    0387-821X
  • Data Source
    J-STAGE 
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