未诊断呼吸系疾病人群中慢性阻塞性肺疾病患病率调查

Prevalence of chronic obstructive pulmonary disease in the population not previously diagnosed with respiratory disease

目的了解未诊断过呼吸系疾病的人群中慢性阻塞性肺疾病(COPD)的患病率以及吸烟对其影响。方法分析471例非呼吸系疾病者肺功能及病史,以第一秒用力呼气容积/用力肺活量(FEV1/FVC)<70%作为COPD诊断标准。结果吸烟和非吸烟组年龄无统计学差异(P>0.05),吸烟组的各项通气指标占预计值的百分比均显著低于非吸烟组(P<0.01)。符合COPD诊断标准的有20例,占该人群的4.25%;吸烟组患病率为8.02%,明显高于非吸烟组(2.27%,P<0.01);在无临床症状人群中,COPD患病率为3.12%,其中吸烟者达到6.34%,而非吸烟者为1.45%,两者有显著差异(P<0.01);咳嗽组和气闷组符合COPD诊断标准的分别为21.74%和6.45%。按照COPD严重度分级,Ⅰ级4例,Ⅱ级11例,Ⅲ级5例。结论未诊断过呼吸系疾病人群中,存在一定比例的COPD,吸烟者中比例更高。早期进行肺功能检查,可有效减少COPD的漏诊和误诊。

Objective To evaluate the prevalence of chronic obstructive pulmonary disease （COPD） in the population not previously diagnosed with respiratory disease and the effects of cigarette smoking on it. Methods Clinical data of 471 non-respiratory disease subjects who had undertook pulmonary function tests during the year of 2005 were analyzed. The forced expired volume in one second/vital capacity （FEV1/FVC） 〈70% was diagnosed as COPD. Results There was no difference in the age between smoker and non - smoker groups （P〉0. 05）. The vital capacity （VC）, FVC, FEV1 and forced expired flow at25% -75% VC （FEF25 and FEF75） predicted in the smokers were significantly lower than those in the non-smokers （ P 〈0. 01 ）. Total prevalence of COPD in this population was 4.25% ; the prevalence in the smokers was significantly higher than in the nonsmokers （ 8.02% vs 2.27%, P 〈 0. 01 ）. The prevalence of COPD was 3. 12% in the asymptomatic group. The prevalence was also higher in the asymptomatic smokers than in the asymptomatic nonsmokers （6. 34% vs 1.45%, P 〈0. 01 ）. The COPD prevalence was 21.74% and 6. 45% in cough and chest tight group respectively. According to COPD severity classifying standard, there were 4 mild, 11 moderate and 5 severe in those 20 subjects. Conclusion The prevalence of COPD in the population not previously diagnosed respiratory disease was high, especially in smokers. It might avoid the underestimate of COPD if taking pulmonary function tests earlier.