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中国非吸烟者中的慢性阻塞性肺疾病

COPD in Chinese nonsmokers.

作者信息

Zhou Y, Wang C, Yao W, Chen P, Kang J, Huang S, Chen B, Wang C, Ni D, Wang X, Wang D, Liu S, Lu J, Zheng J, Zhong N, Ran P

机构信息

The State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Diseases, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.

出版信息

Eur Respir J. 2009 Mar;33(3):509-18. doi: 10.1183/09031936.00084408.

Abstract

Little is known about chronic obstructive pulmonary disease (COPD) in Chinese nonsmokers. The present study aimed to investigate the profiles of COPD among nonsmokers based on the Chinese Epidemiological Survey of COPD (CESCOPD). In the CESCOPD, 20,245 subjects aged 40 yrs or older were interviewed with questionnaires and spirometry tests. Subjects with a post-bronchodilator forced expiratory volume in one second (FEV(1))/forced vital capacity (FVC) ratio of <0.70 were identified as having COPD. Data of 12,471 nonsmokers and 1,024 smoking COPD patients were analysed in the current study. The overall prevalence of COPD among nonsmokers was 5.2% (95% confidence interval 4.8-5.6). Being male, of advanced age, lower body mass index (BMI) and lower educational level, having exposure to environmental tobacco smoke, coal and/or biomass smoke, poor ventilation in the kitchen, a family history of respiratory disease and recurrent childhood cough were all independently associated with a higher risk of having COPD among nonsmokers. Nonsmokers with respiratory symptoms without airflow limitation showed a somewhat different pattern of risk factors. Nonsmokers with COPD were less likely to present with chronic productive coughs and lower BMI, while more likely to have received a physician diagnosis of asthma and respiratory diseases in childhood, than smokers with COPD. Chronic obstructive pulmonary disease is prevalent among Chinese nonsmokers, and nonsmoking chronic obstructive pulmonary disease may have different profiles from smoking chronic obstructive pulmonary disease.

摘要

关于中国非吸烟人群中的慢性阻塞性肺疾病(COPD),人们了解甚少。本研究旨在基于中国慢性阻塞性肺疾病流行病学调查(CESCOPD)调查非吸烟人群中COPD的特征。在CESCOPD中,对20245名年龄在40岁及以上的受试者进行了问卷调查和肺活量测定。支气管扩张剂使用后一秒用力呼气容积(FEV(1))/用力肺活量(FVC)比值<0.70的受试者被确定为患有COPD。本研究分析了12471名非吸烟者和1024名吸烟的COPD患者的数据。非吸烟者中COPD的总体患病率为5.2%(95%置信区间4.8 - 5.6)。男性、高龄、较低的体重指数(BMI)、较低的教育水平、接触环境烟草烟雾、煤炭和/或生物质烟雾、厨房通风不良、呼吸道疾病家族史以及儿童期反复咳嗽均与非吸烟者患COPD的较高风险独立相关。有呼吸道症状但无气流受限的非吸烟者显示出略有不同的危险因素模式。与吸烟的COPD患者相比,患有COPD 的非吸烟者出现慢性咳痰的可能性较小,BMI较低,而童年时期更有可能被医生诊断为哮喘和呼吸道疾病。慢性阻塞性肺疾病在中国非吸烟人群中很普遍,并且非吸烟慢性阻塞性肺疾病可能具有与吸烟慢性阻塞性肺疾病不同的特征。

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