Hansen Jens G, Pedersen Lars, Overvad Kim, Omland Øyvind, Jensen Henrik K, Sørensen Henrik Toft
Department of Clinical Epidemiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark.
COPD. 2008 Dec;5(6):347-52. doi: 10.1080/15412550802522635.
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of disability and death in the world. Many people with disease are undiagnosed or untreated due to lack of consensus about the definition of COPD. The objective was to estimate the prevalence of COPD in the Danish population aged 45-84 years and to identify the proportion of persons not receiving appropriate medical treatment. A population-based study in the two Danish counties (population aged 45-84 years = 299,000 persons) based on data from 155 general practices in the 2004-2006 period. Stratified sampling was used to select 4,757 subjects from the Danish Civil Registration System and the National Health Service databases. The diagnosis of COPD was defined as FEV(1)/FVC < 0.70 after bronchodilator. The classification of disease severity was based on criteria developed by the Global Initiative for Chronic Obstructive Lung Diseases (GOLD) criteria. COPD prevalence was associated with sex, age, and smoking status. We found an overall COPD prevalence of 12% (95% CI 11%-13%). Standardized to the Danish population, the true prevalence of COPD is 9% (95% CI 8%-10%). The highest prevalence was observed among current smokers (23%) and former smokers (17%) as well as in the older age group (total = 18%; men = 21%; women = 15%). Most subjects with COPD had mild-to-moderate disease. Among subjects with severe and very severe COPD, 25% were not treated with bronchodilator or inhaled corticosteroids. In conclusion we found that the population prevalence of COPD is high among smokers. A large proportion of persons with COPD did not receive appropriate medical treatment.
慢性阻塞性肺疾病(COPD)是全球致残和致死的主要原因之一。由于对COPD定义缺乏共识,许多患者未被诊断或治疗。目的是估计丹麦45 - 84岁人群中COPD的患病率,并确定未接受适当药物治疗的人群比例。基于2004 - 2006年期间155家全科诊所的数据,在丹麦两个县开展了一项基于人群的研究。采用分层抽样从丹麦民事登记系统和国家卫生服务数据库中选取4757名受试者。COPD的诊断定义为支气管扩张剂使用后FEV(1)/FVC < 0.70。疾病严重程度分类基于慢性阻塞性肺疾病全球倡议(GOLD)标准。COPD患病率与性别、年龄和吸烟状况相关。我们发现总体COPD患病率为12%(95%CI 11% - 13%)。按照丹麦人群标准化后,COPD的实际患病率为9%(95%CI 8% - 10%)。当前吸烟者(23%)、既往吸烟者(17%)以及老年人群(总计18%;男性21%;女性15%)中患病率最高。大多数COPD患者病情为轻度至中度。在重度和极重度COPD患者中,25%未接受支气管扩张剂或吸入性糖皮质激素治疗。总之,我们发现吸烟者中COPD的人群患病率较高。很大一部分COPD患者未接受适当的药物治疗。