沈阳市部分社区慢性阻塞性肺疾病发病情况调查分析

The investigation on the COPD morbility in communities of Shenyang

目的了解沈阳社区慢性阻塞性肺疾病(COPD)的流行病学特点及相关危险因素,为COPD的社区防治提供依据。方法以整群、不等比、随机抽样方法,对2003年3月至10月沈阳市东陵区3个社区,40岁以上人群入户问卷调查及肺功能检查。结果资料完整且肺功能检查质控合格者1957例,其中男725例,女1232例。年龄平均(59.37±11.61)岁。COPD患病率为8.02%,其中男性患病率(11.59%)高于女性(5.93%)(P<0.01)。>60～80岁COPD患病率77.70%,明显高于其他年龄组(P<0.01)。Ⅱ级患者占48.41%,明显高于其他级别(P<0.01)。有咳嗽、咳痰和(或)气短者仅占31.85%。吸烟与COPD患病的OR值为6.39。吸烟率56.05%均显著高于正常人群(9.61%)(P<0.01)。40岁以上COPD患病率显著高于哮喘(1.58%)和(或)COPD合并哮喘患病率(1.74%)。97.45%的患者为首次接受肺功能检查,93.63%为首次诊断为COPD。结论沈阳市社区40岁以上人群COPD患病率显著高于哮喘及COPD合并哮喘者。>60～80岁为高发年龄,Ⅰ、Ⅱ级患者占大多数。COPD的发病主要与吸烟相关。COPD漏诊率高,普及肺功能检查是早期诊断的关键。

Objective To investigate the COPD epidemiologic characteristics and risk factors in urban communities of Shenyang and to provide the scientific basis for the COPD prevention and management in communities. Methods Using the method of random disproportional cluster sampling, several questionnaire and lung function tests were performed to all the individuals over 40 years old in three communities in Dongling district of Shenyang. Results 1957 cases of which has complete personal information and well-done lung function test results. Among them ,725 cases were male, 1232 cases were female. The average ages were（59. 37 ±11.61 ）years old. The COPD mobility was 8. 02% ,male patients（ 11.59% ）were higher than the female（5.93% ） （P 〈0. 01 ）. The COPD mobility of patients aged from 〉 60 N 80 was 77. 70%, which was significantly higher than other age group （ P 〈 0. 01 ）. The percentage of stage Ⅱ patients was 48.41% ,which was significantly higher than other stages in severity（P 〈 0.01 ）. The percentage of patients with cough, sputum and/or dyspnea was only 31.85%. The odd ratio （OR）for COPD in smokers was 6. 39. The percentage of smoking in COPD patients was 56.05% ,which was significantly higher than normals （9. 61% ） （ P 〈 0. 01 ）. The COPD mobility of patients over 40 years old was significantly higher than that of asthma（ 1.58% ） and/or COPD combined with asthma（ 1.74% ）. 97.45% patients received lung function examination for the first time and 93.63% patients were first diagnosed as COPD. Conclusion The COPD mobility of individuals over 40 years old was significantly higher than that of asthma and COPD combined with asthma. Individuals from 〉 60 to 80 years old were with higher prevalence. Most individuals were in stage Ⅰ and Ⅱ. The occurrence of COPD was mainly related to smoking. The missed diagnosing rate of COPD was relatively high. The wide used lung function test was the key of the early diagnosis of COPD.