Menezes A M B, Perez-Padilla R, Hallal P C, Jardim J R, Muiño A, Lopez M V, Valdivia G, Pertuze J, Montes de Oca M, Tálamo C
Post-graduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
Int J Tuberc Lung Dis. 2008 Jul;12(7):709-12.
Five Latin American cities: São Paulo, Brazil; Mexico City, Mexico; Montevideo, Uruguay; Santiago, Chile; Caracas, Venezuela.
To describe the burden of chronic obstructive pulmonary disease (COPD) in Latin America.
This is a multicentre study. Post-bronchodilator spirometry was used and the main outcome measure was FEV(1)/FVC < 0.7 (fixed ratio criterion). Global Obstructive Lung Disease (GOLD) stages were also analysed.
The combined population aged > or =40 years in the five countries included in the study was approximately 85.3 million. Of these, it was estimated that 12.2 million have airflow obstruction, which corresponds to our prevalence estimate of 14.3%. The proportion of subjects in Stages II-IV of the GOLD classification was 5.6%. Risk factors presenting the highest aetiological fractions for COPD were age, current smoking, indoor exposure to coal and exposure to dust in the workplace. Smoking, the modifiable factor with the strongest aetiological fraction for COPD, affects 29.2% of adults aged > or =40 years in these cities, corresponding to approximately 25 million smokers in this age group.
Prevention of smoking and exposure to pollutants, such as coal and dust, are the interventions most likely to succeed against COPD in Latin America. The information obtained by a collaborative study has been vast and encouraging for other similar studies.
五个拉丁美洲城市:巴西圣保罗;墨西哥墨西哥城;乌拉圭蒙得维的亚;智利圣地亚哥;委内瑞拉加拉加斯。
描述拉丁美洲慢性阻塞性肺疾病(COPD)的负担情况。
这是一项多中心研究。采用支气管扩张剂后肺量计测定法,主要结局指标为FEV(1)/FVC < 0.7(固定比值标准)。还分析了慢性阻塞性肺疾病全球倡议(GOLD)分期。
纳入研究的五个国家中年龄≥40岁的总人口约为8530万。其中,估计有1220万人存在气流受限,这与我们估计的患病率14.3%相符。GOLD分级II-IV期患者的比例为5.6%。COPD病因占比最高的危险因素为年龄、当前吸烟、室内煤烟暴露和工作场所粉尘暴露。吸烟是COPD病因占比最强的可改变因素,影响这些城市中29.2%的年龄≥40岁成年人,相当于该年龄组约2500万吸烟者。
预防吸烟以及避免接触煤烟和粉尘等污染物,是拉丁美洲预防COPD最有可能成功的干预措施。通过合作研究获得的信息非常丰富,对其他类似研究具有鼓舞作用。