Abstract: Objective　To establish network auxiliary diagnosis and treatment platform of chronic obstructive pulmonary disease（COPD） based on the website（www.copdchina.com）,and to explore the application effect of this platform and provide ideas for how to hierarchical management of COPD patients.Methods　100 COPD voluntary patients who claimed themselves in stable stage were recruited in the Outpatient of Guangzhou Institute of Respiratory Disease/the First Affiliated Hospital of Guangzhou Medical University from January to June in 2015,volunteers registered by website of COPD（www.copdchina.com） filled in their medical history information and relevant screening questionnaires by themselves on the network auxiliary diagnosis and treatment platform of COPD;volunteers with or without COPD were confirmed by return visits of the Outpatient;patients diagnosed with COPD made online doctor-patient communications,online doctors made condition judgments based on the interrogation and uploaded data by patients（heart rate,blood oxygen,chest X-ray/CT,sputum photos） and give treatment advice;patients then consulted community doctors about the rationality of the advice on network diagnosis and treatment;community doctors finally determined diagnosis and treatment plan and uploaded to the website,and analyzed the differences between network diagnosis and treatment opinions and the final diagnosis and treatment plan.Results　Of the 100 volunteers,6 were out of touch due to various reasons,and 94 were actually involved in the study.Based on medical history information and related screening questionnaires,of the 94 volunteers,70（74.5%） were diagnosed with COPD,14（14.9%） were in exclusion of COPD,and the diagnosis of 10（10.6%） were failed.By return visits of the Outpatient Clinic of Guangzhou Institute of Respiratory Disease,finally 34（36.2%） were diagnosed with COPD,5（5.3%） with asthma,1（1.1%） with interstitial lung disease,and 54（57.4%） with other diseases.The 34 patients confirmed with COPD had put forward 192 questions online within three months,of which 162（84.4%） could be solved according to patients’ self-report and network interaction;18（9.4%） needed to be solved in the outpatients as patients were unable to provide complete information,and 12（6.2%） had no association with COPD.Conclusion　The application of COPD network auxiliary diagnosis and treatment platform can screen and remotely manage patients with COPD,but diagnostic accordance rate of COPD is not high,the network questionnaires are needed to be optimized and lung function terminal devices of patients are needed to be developed.

Key words: Pulmonary disease,chronic obstructive, Network hospital, Health management

摘要： 目的　基于网站建立慢性阻塞性肺疾病（慢阻肺，COPD）网络辅助诊疗平台（www.copdchina.com），探讨该平台的应用效果，为COPD患者分级管理提供思路。方法　于2015年1—6月在广州医科大学附属第一医院/广州呼吸疾病研究所门诊招募100例自称是COPD稳定期患者的志愿者，使用慢性阻塞性肺病网（www.copdchina.com）注册，让志愿者自行在慢阻肺网络辅助诊疗平台上填写病史信息以及相关筛查问卷；通过门诊回访确诊志愿者是否患有COPD；确诊的COPD患者在网站上进行在线医患沟通，在线医生根据问诊及患者上传的资料（心率、血氧、胸部X线片/CT、痰液照片）做出病情判断，并给出诊疗意见；患者再向社区医生咨询网络诊疗意见的合理性；社区医生最终确定诊疗方案并上传网站，分析网络诊疗意见与最终诊疗方案的差异。结果　100例志愿者中，有6例因各种原因失联，实际参与的有94例。94例志愿者中，基于病史信息以及相关筛查问卷，有70例（74.5%）诊断为COPD，有14例（14.9%）排除COPD，有10例（10.6%）未能下任何诊断；通过广州呼吸疾病研究所门诊回访，最终确诊有34例（36.2%）诊断为COPD，有5例（5.3%）诊断为哮喘，1例（1.1%）诊断为间质性肺疾病，54例（57.4%）诊断为其他疾病。确诊的34例COPD患者在3个月内，在线提问192条问题，其中有162条（84.4%）可以根据患者自述的情况和网络互动交流得到解决；由于患者无法提供完整的信息，有18条（9.4%）需到门诊就诊解决；另外有12条（6.2%）与COPD无关。结论　应用慢阻肺网络辅助诊疗平台，可以筛查和远程管理COPD患者；但COPD诊断符合率不高，需要优化网络问卷和研制患者终端肺功能仪等。

关键词: 肺疾病, 慢性阻塞性, 网络医院, 健康管理