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苏州慢性阻塞性肺疾病的流行病学及危险因素:一项基于人群的横断面研究。

Epidemiology and risk factors of chronic obstructive pulmonary disease in Suzhou: a population-based cross-sectional study.

作者信息

Yan Xiaopei, Xu Li, Shi Baoyu, Wang Hui, Xu Xiao, Xu Guopeng

机构信息

Department of Pulmonary and Critical Care Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China.

出版信息

J Thorac Dis. 2020 Oct;12(10):5347-5356. doi: 10.21037/jtd-20-1616.

Abstract

BACKGROUND

The prevalence of chronic obstructive pulmonary disease (COPD) in Suzhou remains still unknown. The aim of this study was to quantify the disease burden and assess the risk factors of COPD.

METHODS

This was a population-based, cross-sectional study of adults aged 40 years and older in Suzhou. A total of 4,864 adults were identified from June 2018 to December 2018 and 4,725 adults were finally recruited. Subjects underwent post-bronchodilator spirometry and were diagnosed according to the 2018 Global Initiative for Chronic Obstructive Lung Disease (GOLD).

RESULTS

The data from 4,725 adults were ultimately included in the final analysis. The overall prevalence of COPD in subjects aged 40 and older was 12.4%, while it was 12.3% in men and 12.5% in women. Risk factors identified by multivariable logistic analysis were age (P<0.05, OR =2.29, 95% CI, 1.83-2.88) and underweight (BMI <18.5 kg/m) (P<0.05, OR =1.57, 95% CI, 1.01-2.44). COPD patients also displayed weaker grip strength (P<0.001). Approximately half (50.7%) the COPD patients were asymptomatic, and compared with asymptomatic COPD patients, symptomatic COPD patients were older (69.5 67.2, P<0.05), smoked more frequently (12.1 7.1 pack year, P<0.05), had a more severe GOLD stage (stage I 27.0% 39.4%, stage II 50.2% 46.8%, stage III 17.0% 11.1%, stage IV 5.8% 2.7%, P<0.05), and a worse lung function index (FEV, FVC, PEF, FEF, FEF, FEF, FEF) (P<0.05).

CONCLUSIONS

COPD was found to be highly prevalent in adults aged 40 years and older in Suzhou. Age and underweight were major risk factors of COPD. Half of the COPD patients were asymptomatic, and displayed decreased lung function upon the onset of respiratory symptoms. Therefore, spirometry screening is essential for the early detection and management of COPD.

摘要

背景

苏州慢性阻塞性肺疾病(COPD)的患病率仍不清楚。本研究旨在量化疾病负担并评估COPD的危险因素。

方法

这是一项基于人群的苏州40岁及以上成年人的横断面研究。2018年6月至2018年12月共确定了4864名成年人,最终招募了4725名成年人。受试者接受支气管扩张剂后肺量计检查,并根据2018年慢性阻塞性肺疾病全球倡议(GOLD)进行诊断。

结果

最终将4725名成年人的数据纳入最终分析。40岁及以上受试者中COPD的总体患病率为12.4%,男性为12.3%,女性为12.5%。多变量逻辑分析确定的危险因素为年龄(P<0.05,OR=2.29,95%CI,1.83-2.88)和体重过轻(BMI<18.5kg/m)(P<0.05,OR=1.57,95%CI,1.01-2.44)。COPD患者的握力也较弱(P<0.001)。约一半(50.7%)的COPD患者无症状,与无症状COPD患者相比,有症状的COPD患者年龄更大(69.5对67.2,P<0.05),吸烟更频繁(12.1对7.1包年,P<0.05),GOLD分期更严重(I期27.0%对39.4%,II期50.2%对46.8%,III期17.0%对11.1%,IV期5.8%对2.7%,P<0.05),肺功能指标更差(FEV、FVC、PEF、FEF、FEF、FEF、FEF)(P<0.05)。

结论

发现COPD在苏州40岁及以上成年人中高度流行。年龄和体重过轻是COPD的主要危险因素。一半的COPD患者无症状,且在出现呼吸道症状时肺功能下降。因此,肺量计筛查对于COPD的早期检测和管理至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc00/7656423/8072a2908643/jtd-12-10-5347-f1.jpg

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