van Durme Yannick M T A, Verhamme Katia M C, Stijnen Theo, van Rooij Frank J A, Van Pottelberge Geert R, Hofman Albert, Joos Guy F, Stricker Bruno H Ch, Brusselle Guy G
Department of Respiratory Diseases, Ghent University Hospital, Ghent, Belgium.
Department of Epidemiology and Biostatistics, Erasmus University Medical Center, Rotterdam, the Netherlands.
Chest. 2009 Feb;135(2):368-377. doi: 10.1378/chest.08-0684.
COPD is a major cause of chronic morbidity and mortality throughout the world. Although the prevalence of COPD is already well documented, there are only few studies regarding the incidence of COPD.
In a prospective population-based cohort study among subjects aged >or= 55 years, COPD was diagnosed with an algorithm based on the validation of hospital discharge letters, files from the general practitioner, and spirometry reports.
In this study cohort of 7,983 participants, 648 cases were identified with incident COPD after a median follow-up time of 11 years (interquartile range, 7.8 years). This resulted in an overall incidence rate (IR) of 9.2/1,000 person-years (PY) [95% confidence interval (CI), 8.5 to 10.0]. The IR of COPD was higher among men (14.4/1,000 PY; 95% CI, 13.0 to 16.0) than among women (6.2/1,000 PY; 95% CI, 5.5 to 7.0), and higher in smokers than in never-smokers (12.8/1,000 PY; 95% CI, 11.7 to 13.9 and 3.9/1,000 PY; 95% CI, 3.2 to 4.7, respectively). Remarkable was the high incidence in the youngest female age category of 55 to 59 years (7.4/1,000 PY; 95% CI, 4.1 to 12.6). For a 55-year-old man and woman still free of COPD at cohort entry, the risk for the development of COPD over the coming 40 years was 24% and 16%, respectively.
The overall incidence of COPD in an elderly population is 9.2/1,000 PY, with a remarkably high incidence in the youngest women, suggesting a further shift toward the female sex in the gender distribution of COPD. During their further lives, one of four men and one of six women free of COPD at the age of 55 years will have COPD develop.
慢性阻塞性肺疾病（COPD）是全球慢性发病和死亡的主要原因。尽管COPD的患病率已有充分记录，但关于COPD发病率的研究却很少。
在一项针对年龄≥55岁人群的前瞻性队列研究中，根据医院出院记录、全科医生档案和肺功能测定报告的验证算法诊断COPD。
在这个包含7983名参与者的研究队列中，经过11年的中位随访时间（四分位间距为7.8年），共识别出648例新发COPD病例。这导致总体发病率（IR）为9.2/1000人年[95%置信区间（CI），8.5至10.0]。男性COPD的发病率（14.4/1000人年；95%CI，13.0至16.0）高于女性（6.2/1000人年；95%CI，5.5至7.0），吸烟者高于从不吸烟者（分别为12.8/1000人年；95%CI，11.7至13.9和3.9/1000人年；95%CI，3.2至4.7）。值得注意的是，55至59岁最年轻女性年龄组的发病率很高（7.4/1000人年；95%CI，4.1至12.6）。对于队列入组时仍无COPD 的55岁男性和女性，在未来40年中发生COPD的风险分别为24%和16%。
老年人群中COPD的总体发病率为9.2/1000人年，最年轻女性的发病率显著较高，这表明COPD的性别分布进一步向女性转移。在55岁时无COPD的男性中，四人中有一人、女性中六人中有一人在其后续生活中会发生COPD。
