“幸福呼吸”项目地区慢性阻塞性肺疾病高危人群筛查现状分析

Screening status of high-risk population of chronic obstructive pulmonary disease in areas where “Happy Breathing” is running

目的分析"幸福呼吸"项目地区慢性阻塞性肺疾病(简称慢阻肺)高危人群筛查现状。方法于2017年11月至2019年10月在"幸福呼吸"项目18个试点地区发放1008518份慢阻肺筛查问卷(COPD-SQ问卷),并对问卷评分≥16分的研究对象中的63523例进行支气管舒张剂吸入前肺功能检查,使用分层分析、χ2检验等统计学方式就慢阻肺高危人群分布情况、高危人群中慢阻肺患病率情况及慢阻肺相关危险因素进行分析。结果慢阻肺高危人群占接受问卷筛查人群18.99%(191498/1008518),在接受肺功能筛查的高危人群中,31.59%(20070/63523)经筛查诊断为慢阻肺患者;对慢阻肺危险因素的分析表明,就COPD-SQ问卷评分≥16分的高危人群比例及高危人群慢阻肺患病率两方面分析,吸烟指数≥600的人群相比不吸烟人群,高危人群比例(54.20%比12.60%)及其慢阻肺患病率(35.62%比25.22%)都明显更高;几乎每天暴露于二手烟环境中的人群较无二手烟暴露的人群亦表现出更高的高危人群比例(27.39%比10.97%)及高慢阻肺患病率(31.36%比27.93%);生物燃料暴露的有无亦造成了高危人群比例(33.92%比13.11%)的差异;具有呼吸系统疾病家族史的人群相较无家族史的人群,其高危人群比例(56.38%比16.42%)及高危人群中慢阻肺患病率(32.40%比29.19%)均较高。结论慢阻肺高危人群在筛查人群中占比高,提示"幸福呼吸"项目在慢阻肺筛查方面具有可行性和必要性,有助于慢阻肺诊疗的发展。

Objective To analyze the screening status of high-risk population of chronic obstructive pulmonary disease(COPD)in areas where“Happy Breathing”project was carried out.Method There were 1008518 COPD screening questionnaires(COPD-SQ)filled out in 18 pilot areas of“Happy Breathing”program from November 2017 to October 2019.Within subjects who scored 16 points or more with COPD-SQ,63523 of them underwent pulmonary function tests before bronchodilator inhalation.Stratified analysis,chi-square test and other statistical methods were performed to analyze the distribution of COPD high-risk groups,the prevalence of COPD among high-risk groups and risk factors of COPD.Results Results in this study suggested that the high-risk population of COPD accounted for 18.99%(191498/1008518)of the population who received the questionnaire screening.Among the high-risk population who received lung function test,31.59%(20070/63523)were screened and diagnosed as COPD patients.As for risk factors of COPD,the proportion of high-risk population was higher in people with a smoking index≥600 compared with never-smokers(54.20%vs 12.60%),and the prevalence of COPD was also higher in people with a smoking index≥600(35.62%vs 25.22%);people who were exposed to second-hand smoke almost every day also showed an increased proportion of high-risk groups(27.39%vs 10.97%)and a high prevalence of COPD(31.36%vs 27.93%)than those without second-hand smoke exposure;the presence or absence of biofuel exposure also caused the difference in the proportion of high-risk groups(33.92%vs 13.11%);compared with people without a family history of respiratory diseases,the proportion of high-risk groups(56.38%vs 16.42%)and the prevalence of COPD in high-risk groups(32.40%vs 29.19%)were both higher in those with family history of respiratory diseases.Conclusion The high-risk group of COPD accounts for a high proportion of the screened population,suggesting that the“Happy Breathing”project is feasible and necessary in COPD screening,which is helpful for the development of COPD diagnosis and treatment.