社区慢性阻塞性肺疾病高危人群的患病状况调查

摘要

目的 了解社区慢性阻塞性肺疾病(COPD)高危人群的患病状况.方法 于2008年4月-2010年4月对北京市月坛社区常住居民中的高危人群进行肺功能测定,确诊或排除COPD,并记录人口学资料、病史、暴露因素等信息.结果 共调查1 253例COPD高危人群,COPD组(A组)212例,非COPD组(B组)1 041例,高危人群COPD患病率达16.9%(212/1 253).年龄、吸烟、有害气体、粉尘、颗粒接触史、既往心肺疾病史等为COPD发病的危险因素.分层研究显示随着年龄的增加,COPD的患病率、吸烟量(吸烟指数)、症状、共患病、用力肺活量(FVC)、1 s用力呼气量(FEV1)间差异均有统计学意义(P＜0.05).A组的212例COPD患者中既往被诊断为慢支、肺气肿26例,诊断为COPD者5例,181例患者未被诊断出慢支、肺气肿或COPD,无症状者60例,COPD患者的漏诊率达85.4%(181/212).结论 社区高危人群COPD发病率高,COPD患者合并其他系统性疾病的发生率高.COPD发病隐匿,漏诊率极高,对高危人群进行肺功能检查可发现早期COPD患者,从而提高COPD诊断率,有利于早期防治.%Objective To investigate the morbidity rate of chronic obstructive pulmonary disease ( COPD ) among high risk populations in the community.Methods Pulmonary functions were evaluated among residents with high risk factors of COPD in Yuetan community from April in 2008 to April in 2010, resulting in either diagnosis or exclusion of COPD.Demographic information, history, and risk factors were recorded at the same time.Results A total of 1 253 subjects with high risk factors of COPD were surveyed.Of them, 212 were COPD patients ( group A), 1 041 were non - COPD controls ( group B ).The incidence rate of COPD in high risk population was 16.9％ ( 212/1 253 ).Age, cigarette smoking, harmful gases and irritant gases, powder dust, grana - contact history, cardiovascular or pulmonary disease history were among the risk factors of COPD.Stratified analysis showed that differences in incidence rate of COPD, smoking index, symptom, comorbidity, force vital capacity ( FVC ) and forced expiratory volume in first second ( FEV, ) were significant among different age groups ( P ＜ 0.05 ).Of 212 COPD patients in group A, 26 had been diagnosed with chronic bronchitis or emphysema in the past, 5 had been diagnosed with COPD, still 181 patients were with no previous diagnosis of chronic bronchitis or emphysema or COPD.In addition, 60 of the COPD patients were silent with no obvious symptoms.The rate of missed diagnosis was 85.4％ ( 181/212 ) in COPD patients.Conclusion The incidence rate of COPD was high among high risk population, so is the incidence of comorbidity with other systemic diseases.The emergence of COPD was hard to perceive, which lead to a high rate of missed diagnosis.Evaluation of pulmonary functions among high risk population might aid early diagnoses of these patients and thus improve prevention and treatment in early stage.