基于吉林省长春市区居民肺功能筛查的慢性阻塞性肺疾病患病现况调查分析

doi:10.13481/j.1671-587x.20170536

吉林大学学报(医学版) ›› 2017, Vol. 43 ›› Issue (05): 1047-1052.doi: 10.13481/j.1671-587x.20170536

基于吉林省长春市区居民肺功能筛查的慢性阻塞性肺疾病患病现况调查分析

张雪阳^1,2, 马骥³, 孟广平¹, 王琦¹, 李伟¹, 徐艳玲¹, 张捷¹, 高鹏¹

1. 吉林大学第二医院呼吸与危重症医学科, 吉林长春 130041;
2. 首都医科大学附属潞河医院急诊科, 北京 101100;
3. 北京市通州区新华医院骨科, 北京 101100

收稿日期:2017-01-15 出版日期:2017-09-28 发布日期:2017-09-29
通讯作者: 高鹏,副教授,硕士研究生导师(Tel:0431-88796866,E-mail:gaopeng1234@sina.com) E-mail:gaopeng1234@sina.com
作者简介:张雪阳(1991-),女,吉林省松原市人,住院医师,医学硕士,主要从事慢性阻塞性肺疾病诊断及治疗方面的研究。
基金资助:
吉林省科技厅医药产业发展引导资金项目资助课题（20150311066YY）

Analysis on prevalence of chronic obstructive pulmonary disease based on pulmonary function screening in Changchun urban area of Jilin province

ZHANG Xueyang^1,2, MA Ji³, MENG Guangping¹, WANG Qi¹, LI Wei¹, XU Yanling¹, ZHANG Jie¹, GAO Peng¹

1. Department of Respiratory and Critical Care Medicine, Second Hospital, Jilin University, Changchun 130041, China;
2. Department of Emergency, Luhe Hospital, Capital Medical University, Beijing 101100, China;
3. Department of Orthopaedics, Beijing Tongzhou Xinhua Hospital, Beijing 101100, China

Received:2017-01-15 Online:2017-09-28 Published:2017-09-29

摘要/Abstract

摘要： 目的：调查吉林省长春市区40周岁以上居民慢性阻塞性肺疾病（COPD）的患病现况，阐明肺功能检查早期应用的重要意义。方法：选择以吉林大学第二医院为中心的周边10个社区街道办事处，由社区工作人员协助随机招募年龄≥ 40周岁的长春市居民作为调查对象，主要进行问卷调查及肺功能检查，COPD诊断参照2015年GOLD指南标准执行。将COPD患者分为确诊组和漏诊组，再将吸烟COPD患者分为戒烟组和未戒烟组，分别比较各组肺功能指标。结果：共调查40周岁以上居民1392人，其中男性568人，女性824人，平均年龄为（59.59±6.60）岁。其中COPD患者176例，患病率为12.64%；新发现即漏诊患者160例，漏诊率为90.91%；曾确诊为COPD16例，诊断率仅为9.09%。吸烟人群中COPD患病率为20.71%，明显高于非吸烟人群的患病率（8.8%，P < 0.05）。对吸烟指数和COPD患者肺功能进行相关性分析，戒烟组患者肺功能指标除用力肺活量占预计值的百分比（FVC%）、最大呼气中期流速占预计值的百分比（MMEF%）外均随着吸烟指数的增加而下降（P < 0.05），未戒烟组COPD患者肺功能指标除FVC%外均随着吸烟指数的增加而下降（P < 0.05）。结论：长春市区40周岁以上居民COPD存在高患病率及高漏诊率，应对人群进行肺功能筛查以发现更多的COPD患者，使其得到早期诊治。

关键词: 慢性阻塞性肺疾病, 患病率, 肺功能, 吸烟

Abstract: Objective: To investigate the prevalence of chronic obstructive pulmonary disease (COPD) in the adults aged 40 years old and over in Changchun urban area, and to clarify the important significance of early application of pulmonary function examination. Methods: With the help of community workers,10 communities which around Second Hospital of Jilin University were selected and the participants aged 40 years old and over were randomly collected. COPD questionnaire and pulmonary function examination were conducted in all subjects. The patients with COPD were diagnosed according to the criteria established by the Global Initiative for COPD (GOLD). The patients with COPD were divided into the diagnostic group and undiagnostic group,then the patients with COPD who had smoking history were divided into smoking cessation group and smoking group.The pulmonary function of each groups were compared. Results: A total of 1 392 participants aged 40 years old and over were recruited in this survey, including 568 males and 824 females, and their average age was (59.59±6.60) years. Totally 176 subjects were diagnosed as COPD, and the prevalence was 12.64%. Furthermore, 160 of them were newly diagnosed, which showed the undiagnostic rate of COPD was 90.91%. Among the 176 patients with COPD, 16 had been confirmed before, which meant only 9.09% patients got the accurate diagnose before.The analysis of high-risk factor(smoking) showed that the population had an increased prevalence of COPD (20.71%) compared with non-smokers (8.8%)(P<0.05).The correlational analysis between smoking index and the pulmonary function of the patients with COPD showed that all of the pulmonary function indexes except forced vital capacity(FVC%) and maximum midexpiratory flow(MMEF%)in smoking cessation group were descended along with the increase of smoking index(P<0.05).All of the pulmonary function indexes except FVC% in smoking group were descended along with the increase of smoking index(P<0.05). Conclusion: The high prevalence and underdiagnostic rate of COPD are found in the residents aged 40 years old and over in Changchun urban area.More patients with COPD should be screened by performing pulmonary function examination to treat them at an early stage.

Key words: chronic obstructive pulmonary disease, prevalence rate, pulmonary function, smoking

中图分类号:

R563.3

张雪阳, 马骥, 孟广平, 王琦, 李伟, 徐艳玲, 张捷, 高鹏. 基于吉林省长春市区居民肺功能筛查的慢性阻塞性肺疾病患病现况调查分析[J]. 吉林大学学报(医学版), 2017, 43(05): 1047-1052.

ZHANG Xueyang, MA Ji, MENG Guangping, WANG Qi, LI Wei, XU Yanling, ZHANG Jie, GAO Peng. Analysis on prevalence of chronic obstructive pulmonary disease based on pulmonary function screening in Changchun urban area of Jilin province[J]. Journal of Jilin University Medicine Edition, 2017, 43(05): 1047-1052.

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基于吉林省长春市区居民肺功能筛查的慢性阻塞性肺疾病患病现况调查分析

Analysis on prevalence of chronic obstructive pulmonary disease based on pulmonary function screening in Changchun urban area of Jilin province

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