中国慢性阻塞性肺疾病的疾病负担:一项系统评价。

Disease burden of COPD in China: a systematic review.

作者信息

Zhu Bifan, Wang Yanfang, Ming Jian, Chen Wen, Zhang Luying

机构信息

Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China.

The First Affiliated Hospital of Wannan Medical College, Wuhu, China.

出版信息

Int J Chron Obstruct Pulmon Dis. 2018 Apr 27;13:1353-1364. doi: 10.2147/COPD.S161555. eCollection 2018.

Abstract

Chronic obstructive pulmonary disease (COPD) is one of the main contributors to the global burden of disease. The aim of this systematic review was to quantify the disease burden of COPD in China and to determine the risk factors of the disease. The number of studies included in the review was 47 with an average quality assessment score of 7.70 out of 10. Reported COPD prevalence varied between 1.20% and 8.87% in different provinces/cities across China. The prevalence rate of COPD was higher among men (7.76%) than women (4.07%). The disease was more prevalent in rural areas (7.62%) than in urban areas (6.09%). The diagnostic rate of COPD patients in China varied from 23.61% to 30.00%. The percentage of COPD patients receiving outpatient treatment was around 50%, while the admission rate ranged between 8.78% and 35.60%. Tobacco exposure and biomass fuel/solid fuel usage were documented as two important risk factors of COPD. COPD ranked among the top three leading causes of death in China. The direct medical cost of COPD ranged from 72 to 3,565 USD per capita per year, accounting for 33.33% to 118.09% of local average annual income. The most commonly used scales for the assessment of quality of life (QoL) included Saint George Respiratory Questionnaire, Airways Questionnaire 20, SF-36, and their revised versions. The status of QoL was worse among COPD patients than in non-COPD patients, and COPD patients were at higher risks of depression. The COPD burden in China was high in terms of economic burden and QoL. In view of the high smoking rate and considerable concerns related to air pollution and smog in China, countermeasures need to be taken to improve disease prevention and management to reduce disease burdens raised by COPD.

摘要

慢性阻塞性肺疾病(COPD)是全球疾病负担的主要促成因素之一。本系统评价的目的是量化中国COPD的疾病负担,并确定该疾病的危险因素。纳入该评价的研究有47项,平均质量评估得分为7.70(满分10分)。在中国不同省份/城市,报告的COPD患病率在1.20%至8.87%之间。COPD患病率男性(7.76%)高于女性(4.07%)。该疾病在农村地区(7.62%)比城市地区(6.09%)更普遍。中国COPD患者的诊断率在23.61%至30.00%之间。接受门诊治疗的COPD患者比例约为50%,而住院率在8.78%至35.60%之间。烟草暴露和生物质燃料/固体燃料使用被记录为COPD的两个重要危险因素。COPD在中国是三大主要死因之一。COPD的人均直接医疗费用每年在72美元至3565美元之间,占当地年均收入的33.33%至118.09%。评估生活质量(QoL)最常用的量表包括圣乔治呼吸问卷、气道问卷20、SF-36及其修订版。COPD患者的生活质量状况比非COPD患者差,且COPD患者患抑郁症的风险更高。中国的COPD负担在经济负担和生活质量方面都很高。鉴于中国吸烟率高以及对空气污染和雾霾的高度关注,需要采取对策来改善疾病预防和管理,以减轻COPD带来的疾病负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b16/5927339/f0c817e64ddf/copd-13-1353Fig1.jpg

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