Peña V S, Miravitlles M, Gabriel R, Jiménez-Ruiz C A, Villasante C, Masa J F, Viejo J L, Fernández-Fau L
Respiratory Pathology Unit, Cruces Hospital, Baracaldo.
Chest. 2000 Oct;118(4):981-9. doi: 10.1378/chest.118.4.981.
To ascertain the prevalence, diagnostic level, and treatment of COPD in Spain through a multicenter study comprising seven different geographic areas.
This is an epidemiologic, multicenter, population-based study conducted in seven areas of Spain. A total of 4,035 men and women (age range, 40 to 69 years) who were randomly selected from a target population of 236,412 subjects participated in the study.
Eligible subjects answered the European Commission for Steel and Coal questionnaire. Spirometry was performed, followed by a bronchodilator test when bronchial obstruction was present.
The prevalence of COPD was 9.1% (95% confidence interval [CI], 8.1 to 10.2%), 15% in smokers (95% CI, 12.8 to 17.1%), 12.8% in ex-smokers (95% CI, 10.7 to 14.8%), and 4.1% in nonsmokers (95% CI, 3.3 to 5.1%). The prevalence in men was 14.3% (95% CI, 12.8 to 15. 9%) and 3.9% in women (95% CI, 3.1 to 4.8%). Marked differences were observed between sexes in smoking; the percentage of nonsmokers was 23% in men and 76.3% in women (p<0.0001). The prevalence of COPD varied among the areas, ranging from 4.9% (95% CI, 3.2 to 7.0%) in the area of the lowest prevalence to 18% (95% CI, 14.8 to 21.2%) in the area of the highest. There was no previous diagnosis of COPD in 78.2% of cases (284 of 363). Only 49.3% of patients with severe COPD, 11.8% of patients with moderate COPD, and 10% of patients with mild COPD were receiving some kind of treatment for COPD. Multivariate analysis showed that individuals had a higher probability of having received a previous diagnosis of COPD if they lived in urban areas, were of male gender, were > 60 years old, had higher educational levels, had > 15 pack-year smoking history, or had symptoms of chronic bronchitis.
COPD is a very frequent disease in Spain, and presents significant geographic variations and a very low level of previous diagnosis and treatment, even in the most advanced cases.
通过一项涵盖七个不同地理区域的多中心研究，确定西班牙慢性阻塞性肺疾病（COPD）的患病率、诊断水平及治疗情况。
这是一项在西班牙七个地区进行的基于人群的多中心流行病学研究。从236,412名目标人群中随机选取了4035名男性和女性（年龄范围40至69岁）参与研究。
符合条件的受试者回答欧洲煤钢共同体问卷。进行肺量计检查，若存在支气管阻塞则接着进行支气管扩张试验。
COPD的患病率为9.1%（95%置信区间[CI]，8.1%至10.2%），吸烟者中为15%（95%CI，12.8%至17.1%），既往吸烟者中为12.8%（95%CI，10.7%至14.8%），非吸烟者中为4.1%（95%CI，3.3%至5.1%）。男性患病率为14.3%（95%CI，12.8%至15.9%），女性为3.9%（95%CI，3.1%至4.8%）。观察到男女吸烟情况存在显著差异；男性非吸烟者比例为23%，女性为76.3%（p<0.0001）。COPD患病率在各地区有所不同，从患病率最低地区的4.9%（95%CI，3.2%至7.0%）到患病率最高地区的18%（95%CI，14.8%至21.2%）。78.2%的病例（363例中的284例）此前未被诊断为COPD。重度COPD患者中仅49.3%、中度COPD患者中11.8%、轻度COPD患者中10%正在接受某种COPD治疗。多因素分析显示，居住在城市地区、男性、年龄>60岁、教育水平较高、吸烟史>15包年或有慢性支气管炎症状的个体，此前被诊断为COPD的可能性更高。
COPD在西班牙是一种非常常见的疾病，存在显著的地理差异，且既往诊断和治疗水平极低，即使在最严重的病例中也是如此。
