Objective To investigate the COPD diagnostic situation in an urban community of Beijing.Methods The residents in Shishahai community Beijing, aged 40 ～ 75 years, were recruited voluntarily.Written informed consents were acquired from all subjects.Thereafter a questionnaire survey was conducted and spirometry was performed.COPD was defined as a ratio of forced expiratory volume in the first second of expiration to forced expiratory volume in 6s (FEV1/FEV6) of less than 0.7 after use of postbronchodilator.Results 1290 subjects had express the willing to take part in the study voluntarily.The 1270 subjects had passed the screening criteria and 1261 subjects were available for the analysis due to performing both the eligible questionnaire and the spirometry test.382 were male,aged 59.8 ± 9.0 and 879 were female, aged 57.1 ± 9.0.77 subjects were diagnosed COPD.The overall prevalence of COPD was 6.10％ ( 10.21％ among men,and 4.32％ among women, ).Only 24.68％ ( 19/77 ) of the COPD patients had been diagnosed previously.49.35％ (38/77) were asymptomatic among these COPD patients.The percentage of asymptomatic COPD was 82.14％ in GOLD stage Ⅰ, 33.33％ in stage Ⅱ ,20.00％ in stage Ⅲ ,and 0％in stage Ⅳ.The diagnosis rate among GOLD stage Ⅰ was only 3.57％.The underdiagnosis of COPD in this group was significantly with GOLD stage Ⅰ but not with age, genders, educational level, average family income per capita and cumulative amount of cigarette smoke.Conclusions COPD is a common disease in the urban area of Beijing.The Underdiagnosis of COPD was so common which may be mainly due to the milder symptoms in the earlier stage.It is urgent to improve the knowledge of COPD among publics and to improve the ability of GPs of recognizing and diagnosing of COPD.%目的 了解北京市什刹海社区常住居民COPD患病及诊断情况.方法 对北京市什刹海社区年龄在40～75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及其他疾病情况,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、饮酒史、职业、收入情况等.肺功能测定第1秒用力呼气容积(FEV1)及6秒用力呼气容积(FEV6),对FEV1/FEV6<70%的受试者行支气管舒张试验.吸入沙丁胺醇气雾剂200μg后FEV1/FEV6<70%者诊断为COPD.结果 共对1290例受试者进行筛选,符合纳入标准者1270例,完成合格问卷及肺功能检测者共1261例,平均年龄58.0±9.1岁.其中男382例,平均年龄59.8±9.0岁;女879例,平均年龄57.1±9.0岁.诊断为COPD 77例,其中男39例(50.6%),女38例(49.4%).COPD患病率为6.10%,其中男性患病率10.21%,女性患病率4.32%.COPD患者平均年龄62.4±9.8岁.COPD患者中既往明确诊断COPD受试者仅24.68%(19/77).无症状患者为49.35%(38/77),多为COPD早期(GOLDⅠ级占82.14%,Ⅱ级占33.33%,Ⅲ级占20.00%,Ⅳ级占0%),而GOLD Ⅰ级 COPD患者诊断率仅为3.57%.COPD漏诊与GOLD Ⅰ级明显相关(P=0.034),而与年龄、性别、教育水平、收入水平、累积吸烟量与COPD是否漏诊并无明显关联.结论 COPD是北京市区居民常见疾病,但诊断率低,漏诊率高.目前迫切需要提高社区居民中对COPD的认知度,并增强社区医生对COPD的识别能力,提高诊断水平.
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