粤北地区慢性阻塞性肺疾病患病率调查

目的　调查广东省粤北地区40岁以上人群慢性阻塞性肺疾病(COPD)的患病率及其危险因素。方法　采用统一的流行病学调查表格,以整群随机抽样方法,在韶关北部山区共调查 40 岁以上居民1498人,并进行肺功能检测,有支气管阻塞者行扩张试验。结果　资料完整的 1468 人,男性640人,女性828人,平均年龄54.3岁。COPD总患病率为12.0%(176/1468),男性患病率18.3%(117/640),显著高于女性患病率7.1%(59/828),P<0.01。只有80.7%COPD患者有咳嗽、咯痰、呼吸困难或气短等症状之一。该地区COPD诊断率过低,只有26.1%的 COPD病例曾诊断过慢性支气管炎、肺气肿或COPD。吸烟是极为重要的危险因素,78.4%COPD患者有吸烟史。该地区居民生物燃料暴露与COPD患病的关系尚待进一步研究。结论　粤北农村地区 COPD患病率远高于预期,吸烟是极为重要的危险因素。肺功能在COPD的诊断,尤其是早期诊断中非常重要。

Study on the prevalence rate of chronic obstructive pulmonary disease in northern part of Guangdong province

OBJECTIVE: To investigate the prevalence of chronic obstructive pulmonary disease (COPD) and its risk factors in population over 40 years old in northern part of Guangdong province. METHODS: Using uniform scheme, procedures and questionnaire, a cluster-randomized-sampling survey for the population aged over 40 years in a rural area of Shaoguan in the northern part of Guangdong province was performed. Spirometry was performed for every participant, followed by a bronchodilatation test when bronchial obstruction was present. RESULTS: There were 1468 cases with complete data from 1498 people aged >or= 40 years including 640 males, 828 females with an average age of 54.3 years old. The total prevalence of COPD was 12.0%. The prevalence of COPD in males was significantly higher than that in females (18.3% vs. 7.1%, P < 0.01). Only 80.7% of the patients with COPD presented one or more symptoms as cough, phlegm, or dyspnoea. Underdiagnosis of COPD would be quite serious. Only 26.1% of the cases was previously diagnosed to have chronic bronchitis, emphysema, or COPD. Smoking was an important risk factor to COPD and 78.4% of the patients with COPD were smokers. However, relation of biomass and COPD called for further investigation. CONCLUSION: Prevalence of COPD was much higher than expected in the northern part of Guangdong while smoking was an most important risk factor of COPD. Lung function test seemed to be of great importance to COPD diagnosis, especially in the earlier period of COPD.