Gillum R F
Office of Analysis and Epidemiology, National Center for Health Statistics, Hyattsville, Maryland 20782.
J Natl Med Assoc. 1991 May;83(5):393-401.
Chronic obstructive pulmonary disease (COPD) and asthma are significant causes of illness and death in blacks. Racial differences in normal values of pulmonary function tests must be considered in both patient care and research. Assessment of risk factors is an important part of COPD management and prevention. An extensive review of data from the National Center for Health Statistics and from other population-based studies confirmed lower lung volumes in blacks compared to whites. However, the ratio of forced expiratory volume in 1 second to forced vital capacity was not lower in blacks; racial differences in flow rates were inconsistently reported. Thoracic dimensions were smaller in blacks than in whites in healthy populations. The cause and the physiologic and pathophysiologic significance of these racial differences are unknown. Population-based studies in blacks have firmly established only age and cigarette smoking as risk factors for COPD other than asthma. In 1987, 43% of black men aged 45 and older smoked cigarettes compared to only 30% of white men. Further research is needed on racial differences in pulmonary function and the effects of multiple risk factors to enhance understanding of COPD etiology and prevention. More vigorous smoking prevention and cessation efforts should be targeted for blacks by physicians and public health organizations.
慢性阻塞性肺疾病（COPD）和哮喘是黑人患病和死亡的重要原因。在患者护理和研究中，必须考虑肺功能测试正常数值的种族差异。评估风险因素是COPD管理和预防的重要组成部分。对国家卫生统计中心和其他基于人群的研究数据进行的广泛综述证实，与白人相比，黑人的肺容量较低。然而，黑人1秒用力呼气量与用力肺活量的比值并不低；关于流速的种族差异报道并不一致。在健康人群中，黑人的胸廓尺寸比白人小。这些种族差异的原因以及生理和病理生理意义尚不清楚。基于人群的黑人研究仅明确了年龄和吸烟是除哮喘外COPD的风险因素。1987年，45岁及以上的黑人男性中有43%吸烟，而白人男性中这一比例仅为30%。需要进一步研究肺功能的种族差异以及多种风险因素的影响，以加深对COPD病因和预防的理解。医生和公共卫生组织应针对黑人开展更有力的吸烟预防和戒烟工作。
