一汽厂区居民慢性阻塞性肺疾病患病情况调查

The Prevalence of FAW Residents of Chronic Obstructive Pulmonary Disease

目的探讨一汽厂区慢性阻塞性肺疾病（COPD）患病及诊断情况。方法对一汽厂区年龄在45～70岁自愿接受调查的常住居民进行调查,问卷内容包括既往有无诊断COPD及其它疾病情况,呼吸道症状,吸烟史、是否戒烟、吸烟量、吸烟时间、是否有被动吸烟、职业、收入情况等。使用COPD6型肺功能仪进行通气功能测定（测定第1秒用力呼气容积FEV1,及6秒用力呼气容积FEV6）。COPD的诊断标准为：吸入沙丁胺醇2喷（200μg）后FEV1/FEV6〈70%者,诊断为COPD。结果对1300例受试者进行筛选,符合纳入标准者1 270例,完成合格问卷及肺功能的1 261例,平均年龄（58.0±9.1）岁。男382例,平均年龄（59.8±9.0）岁;女879例,平均年龄（57.1±9.0）岁。通过肺功能诊断COPD者77例,年龄（62.4±9.8）岁,总患病率为6.1%。其中男39例,患病率为10.2%;女38例,患病率为4.3%。年龄40～49岁8例（10.4%）;50～59岁17例（22.0%）;60～69岁31例（40.3%）;70～75岁21例（27.3%）。体重指数（BMI）〈18.5 kg/m^2者3例（3.9%）;18.5～23.9 kg/m^2者29例（37.7%）;24～27.9 kg/m^2者34例（44.2%）;≥28 kg/m^2者273例（21.6%）。现在吸烟者19例（24.7%）;已戒烟者17例（22.1%）;被动吸烟者16例（20.8%）;不吸烟者（包括被动吸烟者）41例（53.4%）。其中仅19例既往被诊为COPD,诊断率24.68%。无呼吸道症状者38例（49.35%）。诊断为COPD的受试者中,GOLD分级I级23例（36.36%）,Ⅱ级ll例（40.26%）,Ⅲ级15例（19.48%）,Ⅳ级3例（3.90%）。该调查发现,通过肺功能诊断为COPD受试者中有49.4%（38/77）无咳嗽、咳痰、呼吸困难等呼吸系统症状。GOLD分级I级受试者显著多于Ⅱ级、Ⅲ级、Ⅳ级受试者（P=0.0002）。不同GOLD分级的COPD诊断率：I级l例（1/28,3.57%）;Ⅱ级7例（7/33,21.21%）;Ⅲ级9例（9/15,60.00%）;Ⅳ级2例（2/3,66.67%）。GOLD分级I级COPD诊断率要明显低于Ⅱ级、Ⅲ级、Ⅳ级（P=0.042）。无症状患者与GOLD分级：I级23例（23/28,82.14%）;Ⅱ级11例（11/33,33.33%）;Ⅲ级3例（9/15,20.00%）。结论目前一汽厂区居民COPD患病率较高,但诊断率很低,说明一汽厂区社区的COPD防治措施有待进一步改进和完善。

Objective To investigate the FAW chronic obstructive pulmonary disease（COPD） prevalence and diagnosis.Methods The method of FAW at the age of 45～70 voluntary survey residents conducted a survey, the questionnaire included with or without previousdiagnosis of COPD and other diseases, respiratory symptoms, smoking history, smoking,smoking, smoking time, whether passive smoking, occupation, income etc.Pulmonary function was measured using COPD6 type pulmonary function（FEV1 FEV1 determination,and forced expiratory volume FEV6 6 seconds）. The diagnostic criteria for COPD： 2 sprayinhalation of salbutamol（200 micrograms） of FEV1/FEV670%, diagnosed as COPD.Results A total of 1 300 subjects were screened, 1 270 patients meet the inclusion criteria,1 261 cases of eligible questionnaires and lung function, mean age（58.0 ±9.1） years old. 382 cases were male, mean age（59.8±9.0） years; 879 were female, mean age（57.1±9.0） years old. Through the 77 cases of pulmonary function in the diagnosis of COPD, age（62.4±9.8） years, the total prevalence rate was 6.1%. Of which 39 cases were male, the prevalence rate was 10.2%; 38 cases were female, the prevalence rate is 4.3%. The age of 40 in a 49 year old in 8 cases（10.4%）;50 ～59years old in 17 cases（22.0%）; 60 ～ 69 3L cases（40.3%）; 70～75 years old in 21 cases（27.3%）. Body mass index（BMI） of 3 cases of 18.5 kg/m^2（3.9%）; 29 cases of 18.5～23.9 kg / m^2（37.7%）; 34 cases of 24 ～ 27.9 kg/m^2（44.2%）; more than 273 cases of 28 kg/m^2（21.6%）. Current smokers in 19 cases（24.7%）; 17 cases had quit smoking（22.1%）; 16 cases（20.8%）; passive smokersnonsmokers（including passive smokers） 41 cases（53.4%）. Only 19 patients were diagnosed with COPD, the diagnosis rate of 24.68%. 38 patients without respiratory symptoms（49.35%）. Diagnosis of COPD in subjects with GOLD, I grade 23 cases（36.36%）, grade LL（40.26%） cases, 15 patients（19.48%）, 3 patients with grade IV（3.90%）. The survey found that, through the lung function diagnosis of COPD subjects in 49.4%（38/77） without cough, sputum, dyspnea and other symptoms of respiratory system. GOLD class I subjects were significantly more than grade II, III, IV subjects（P =0.0002）. COPD diagnosis of different GOLD classification rate： I grade L（1 / 28,3.57%）; II in 7 cases（7/33,21.21%）; 9 patients（9/15, 60%）;2 patients with grade IV（2 / 3, 66.67%）. GOLD I grade COPD diagnosis rate was significantly lower than that of grade II, III, IV（P=0.042）. Asymptomatic patients with GOLD grade： I grade 23 cases（23/28,82.14%）; II in 11 cases（11/33,33.33%）;3 patients（9/15,20%）. Conclusion The FAWthe prevalence of COPD is higher, but the diagnosis rate is very low, that FAW COPDcommunity prevention and control measures should be further improved and perfected.