西班牙慢性阻塞性肺疾病的趋势：1997年、2007年和2017年横断面调查之间的变化

Trends of COPD in Spain: Changes Between Cross Sectional Surveys 1997, 2007 and 2017.

作者信息

García Castillo Elena, Alonso Pérez Tamara, Peláez Adrián, Pérez González Patricia, Miravitlles Marc, Alfageme Inmaculada, Casanova Ciro, Cosío Borja G, de Lucas Pilar, García-Río Francisco, Rodríguez González-Moro José Miguel, Soler-Cataluña Juan José, Sánchez Guadalupe, Soriano Joan B, Ancochea Julio

机构信息

Pulmonary Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria La Princesa, Madrid, Spain; School of Medicine, Universidad Autónoma de Madrid (UAM), Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.

出版信息

Arch Bronconeumol. 2023 Mar;59(3):142-151. doi: 10.1016/j.arbres.2022.11.014. Epub 2022 Dec 5.

DOI:10.1016/j.arbres.2022.11.014

PMID:36549937

Abstract

INTRODUCTION

We aim to describe the changes in prevalence and risk factors associated to chronic obstructive pulmonary disease (COPD) in Spain, comparing three population-based studies conducted in three timepoints.

METHODS

We compared participants from IBERPOC conducted in 1997, EPISCAN conducted in 2007 and EPISCAN II in 2017. COPD was defined as a postbronchodilator FEV/FVC (forced expiratory volume in 1s/forced vital capacity) ratio <0.70, according to GOLD criteria; subsequently, also as the FEV/FVC below the lower limit of normal (LLN).

RESULTS

COPD prevalence in the population between 40 and 69 years decreased from 21.6% (95% CI 20.7%-23.2%) in 1997 to 8.8% (95% CI 8.2%-9.5%) in 2017, a 59.2% decline (p<0.001). In 2007, the prevalence was 7.7% (95% CI 6.8%-8.7%) with an upward trend of 1.1 percentage points in 2017 (p=0.073). Overall COPD prevalence decreased in men and women, although a significant increase was observed in the last decade in females (p<0.05). Current smokers significantly increased in the last decades (25.4% in 1997, 29.1% in 2007 and 23.4% in 2017; p<0.001). Regrettably, COPD underdiagnosis was constantly high, 77.6% in 1997, 78.4% in 2007, and to 78.2% in 2017 (p=0.95), higher in younger ages (40-49 yrs and 50-59 yrs) and also higher in women than in men in all three studies (p<0.05).

CONCLUSIONS

We report a significant reduction of 59.2% in the prevalence of COPD in Spain from 1997 to 2017 in subjects aged 40-69 years. Our study highlights the significant underdiagnosis of COPD, particularly sustained in women and younger populations.

摘要

引言

我们旨在描述西班牙慢性阻塞性肺疾病（COPD）患病率及相关风险因素的变化情况，比较在三个时间点开展的三项基于人群的研究。

方法

我们比较了1997年进行的IBERPOC研究、2007年进行的EPISCAN研究以及2017年进行的EPISCAN II研究的参与者。根据全球慢性阻塞性肺疾病倡议（GOLD）标准，COPD定义为支气管扩张剂使用后FEV/FVC（1秒用力呼气容积/用力肺活量）比值<0.70；随后，也定义为FEV/FVC低于正常下限（LLN）。

结果

40至69岁人群中COPD患病率从1997年的21.6%（95%置信区间20.7%-23.2%）降至2017年的8.8%（95%置信区间8.2%-9.5%），下降了59.2%（p<0.001）。2007年患病率为7.7%（95%置信区间6.8%-8.7%），2017年有上升趋势，上升了1.1个百分点（p=0.073）。总体而言，男性和女性的COPD患病率均有所下降，尽管在过去十年中女性患病率显著上升（p<0.05）。在过去几十年中，当前吸烟者显著增加（1997年为25.4%，2007年为29.1%，2017年为23.4%；p<0.001）。遗憾的是，COPD的漏诊率一直很高，1997年为77.6%，2007年为78.4%，2017年为78.2%（p=0.95），在较年轻年龄段（40-49岁和50-59岁）更高，并且在所有三项研究中女性均高于男性（p<0.05）。