摘要目的:调查分析我国呼吸专科医师临床实践中对于门诊稳定期慢性阻塞性肺疾病（慢阻肺）诊断和评估工具应用现状，为推广实施诊疗规范提供参考资料。方法:通过问卷星平台对中国慢阻肺联盟（含94家单位）、北京市慢阻肺联盟（含108家单位）和中国基层呼吸疾病联盟（覆盖除港澳台及西藏外30个省市自治区）的呼吸专科医师发放和回收由研究者自行编制的问卷，调查我国呼吸专科医师对于门诊稳定期慢阻肺诊断和评估工具的应用情况，对结果进行汇总分析。结果:共回收有效问卷3 204份。71.7%（2 297/3 204）的受访医师来自三级医院。75.4%（2 415/3 204）的医师依据吸入支气管舒张剂后的肺功能结果诊断慢阻肺，且三级医院高于二级医院（78.7%比66.9%， P<0.01）。99.3%的医师在诊断过程中会询问/评估呼吸困难症状，但26.8%的医师未使用评分系统（慢阻肺评估测试问卷和改良版英国医学研究委员会呼吸问卷）进行量化评估。尽管83.8%的医师会在工作中使用指南推荐的综合评估（即ABCD分组），但只有45.1%完全依据分组制订初始治疗方案。另外，28.5%的受访医师没有常规检查血嗜酸粒细胞计数，20.1%的医师没有主动询问肺结核病史。 结论:虽然大多数呼吸专科医师在临床实践中能够基本依照指南对门诊稳定期慢阻肺患者进行诊断和评估，但在评估工具的使用上仍有所不足，在诊治规范的推广和培训中应予以重点关注。

abstractsObjective:To investigate the current status of the application of diagnostic and assessment tools for chronic obstructive pulmonary disease(COPD) by respiratory physicians in China.Method:An on-line questionnaire was designed to address the common questions in COPD diagnosis and evaluation, and this survey was conducted through Wechat.Result:A total of 3 204 valid questionnaires were collected. 71.7% of the physicians were from tertiary hospitals. 75.4% of the physicians diagnosed COPD strictly on the basis of lung function results after inhaled bronchodilators, and this percentage was higher in tertiary hospitals than in secondary hospitals(78.71% vs. 66.92%, P<0.01). 99.3% of the physicians evaluated symptoms of dyspnea, but 26.8% of physicians did not use a scoring system(CAT or mMRC) for quantitative assessment. Although 83.8% of physicians would use the guideline-recommended comprehensive assessment(ABCD classification), only 45.1% of them chose initial therapy exactly according to the classification. In addition, 28.3% of physicians did not routinely order blood eosinophil counts and 20.1% did not inquire the history of tuberculosis. Conclusions:Although most respiratory physicians followed the guidelines in the diagnosis and evaluation of COPD, the use of assessment tools was inadequate, which should be addressed in educational programs for COPD management.