无症状慢性阻塞性肺疾病患者特点分析

Characteristics of non-symptomatic chronic obstructive pulmonary disease patients

目的了解北京市农村地区无症状慢性阻塞性肺疾病(COPD)患者的流行病学特点。方法对北京市延庆县5个自然村40岁以上1624名进行入户调查。进行问诊、体检,填写流行病学调查问卷并进行肺功能检查。结果该地区40岁以上COPD患者148例,总患病率为9.1%(148/1624),其中无症状组62例(42%),有症状组86例(58%);无症状COPD的患病率为3.8%(62/1624)。无症状组和有症状组患者性别、年龄、职业、婚姻状况、受教育程度和吸烟情况比较差异均无统计学意义(P均>0.05)。肺功能检测显示,有症状组第一秒用力呼气容积(FEV1)、第一秒用力呼气容积占预计值百分比(FEV1占预计值%)为(1.3±0.7)L、(61±23)%,与无症状组[(1.5±0.6)L、(70±22)%]比较,差异均有统计学意义(P均<0.05)。结论COPD在该地区患病率较高,其中无症状COPD的比例也较高。由于COPD的诊断需要依靠肺功能测定,而早期肺功能受损不太严重时临床症状不明显,因而造成COPD的漏诊和对疾病危害的低估。

Objective To evaluate the epidemiological characteristics of non-symptomatic chronic obstructive pulmonary disease （COPD） patients in a rural area in Beijing. Methods The data of 1 624 people aged more than 40 in 5 villages in Yanqing county in Beijing were collected. Information of medical history and symptom were obtained, and physical examination and lung function test were performed. Results The prevalence of COPD was 9. 1% （ 148/1 624） in this area. In these 148 patients,62（42% ） were nonsymptomatic and 86（58% ） were symptomatic, the prevalence of non-symptomatic COPD being 3.8% （62/ 1 624）. There was no statistical difference in the sex, age, occupation, marriage status, education level and smoking index between the symptomatic and the non-symptomatic groups（ all P 〉 0. 05 ）. The forced expired volume in one second（ FEVI ） and FEV1% predicted were lower in the symptomatic group[ （1.3 ±0. 7 ）L, （61 ± 23） % ] than those in the non-symptomatic group [ （ 1.5 ± 0. 6 ） L, （70 ± 22 ） % ; all P 〈 0. 05 ]. Conclusions The prevalence of COPD was high in this area with a high percentage of non-symptomatic patients. The COPD prevalence might be underestimated due to the symptom free patients.