Halbert R J, Natoli J L, Gano A, Badamgarav E, Buist A S, Mannino D M
Center Life Sciences, Beverly Hills, CA 90212, USA.
Eur Respir J. 2006 Sep;28(3):523-32. doi: 10.1183/09031936.06.00124605. Epub 2006 Apr 12.
The aim of this study was to quantify the global prevalence of chronic obstructive pulmonary disease (COPD) by means of a systematic review and random effects meta-analysis. PubMed was searched for population-based prevalence estimates published during the period 1990-2004. Articles were included if they: 1) provided total population or sex-specific estimates for COPD, chronic bronchitis and/or emphysema; and 2) gave method details sufficiently clearly to establish the sampling strategy, approach to diagnosis and diagnostic criteria. Of 67 accepted articles, 62 unique entries yielded 101 overall prevalence estimates from 28 different counties. The pooled prevalence of COPD was 7.6% from 37 studies, of chronic bronchitis alone (38 studies) was 6.4% and of emphysema alone (eight studies) was 1.8%. The pooled prevalence from 26 spirometric estimates was 8.9%. The most common spirometric definitions used were those of the Global Initiative for Chronic Obstructive Lung Disease (13 estimates). There was significant heterogeneity, which was incompletely explained by subgroup analysis (e.g. age and smoking status). The prevalence of physiologically defined chronic obstructive pulmonary disease in adults aged > or =40 yrs is approximately 9-10%. There are important regional gaps, and methodological differences hinder interpretation of the available data. The efforts of the Global Initiative for Chronic Obstructive Lung Disease and similar groups should help to standardise chronic obstructive pulmonary disease prevalence measurement.
本研究旨在通过系统评价和随机效应荟萃分析，对慢性阻塞性肺疾病（COPD）的全球患病率进行量化。检索了PubMed中1990年至2004年期间发表的基于人群的患病率估计值。纳入的文章需满足以下条件：1）提供COPD、慢性支气管炎和/或肺气肿的总人口或按性别划分的估计值；2）足够清晰地给出方法细节，以确定抽样策略、诊断方法和诊断标准。在67篇被接受的文章中，62个独特的条目产生了来自28个不同国家的101个总体患病率估计值。37项研究中COPD的合并患病率为7.6%，仅慢性支气管炎（38项研究）的合并患病率为6.4%，仅肺气肿（8项研究）的合并患病率为1.8%。26项肺功能测定估计值的合并患病率为8.9%。最常用的肺功能测定定义是慢性阻塞性肺疾病全球倡议组织的定义（13项估计值）。存在显著的异质性，亚组分析（如年龄和吸烟状况）未能完全解释这种异质性。年龄≥40岁成年人中生理定义的慢性阻塞性肺疾病患病率约为9%-10%。存在重要的地区差异，方法学差异阻碍了对现有数据的解读。慢性阻塞性肺疾病全球倡议组织及类似团体的努力应有助于使慢性阻塞性肺疾病患病率测量标准化。
