Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.
Department of Respiratory and Critical Care Medicine, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
Front Public Health. 2023 Mar 1;11:1102509. doi: 10.3389/fpubh.2023.1102509. eCollection 2023.
To compare whether the general population, especially those without characteristic symptoms, need spirometry screening for chronic obstructive pulmonary disease (COPD).
Residents aged > 40 years old in Minhang, Shanghai, China, filled out screening questionnaires and underwent spirometry. The structured questionnaire integrating COPD population screening and COPD screening questionnaire was designed to obtain data on demographic characteristics, risk factors of COPD, respiratory symptoms, lifestyle habits, and comorbidities. We assessed the correlations between variables and COPD and the impact factors of FEV% predicted.
A total of 1,147 residents were included with a newly diagnosed mild to moderate COPD prevalence of 9.4% (108/1,147); half of the patients (54/108) were asymptomatic. Multivariate analysis did not reveal any significant differences in symptoms or lifestyle factors between newly diagnosed COPD patients and non-COPD participants. However, according to the generalized linear model, older age (β = -0.062, < 0.001), male sex (β = -0.031, = 0.047), and respiratory symptoms (β = -0.025, = 0.013) were associated with more severe airflow limitation.
Newly diagnosed COPD patients had few differences compared with the general population, which suggests that a targeted case finding strategy other than general screening was currently preferred. More attention should be paid to respiratory symptoms when making a diagnosis and exploring new therapies and interventions for COPD in the early stage.
比较一般人群,尤其是那些没有特征性症状的人群,是否需要进行慢性阻塞性肺疾病(COPD)的肺量计筛查。
中国上海闵行区年龄>40 岁的居民填写了筛查问卷并进行了肺量计检查。设计了一种整合 COPD 人群筛查和 COPD 筛查问卷的结构化问卷,以获取人口统计学特征、COPD 危险因素、呼吸症状、生活方式习惯和合并症的数据。我们评估了变量与 COPD 之间的相关性以及 FEV%预测值的影响因素。
共纳入 1147 名居民,新诊断的轻度至中度 COPD 患病率为 9.4%(108/1147);其中一半患者(54/108)无症状。多变量分析显示,新诊断的 COPD 患者与非 COPD 参与者在症状或生活方式因素方面没有显著差异。然而,根据广义线性模型,年龄较大(β=-0.062,<0.001)、男性(β=-0.031,=0.047)和呼吸症状(β=-0.025,=0.013)与更严重的气流受限相关。
与一般人群相比,新诊断的 COPD 患者差异较小,这表明目前更倾向于采用有针对性的病例发现策略,而不是一般筛查。在进行诊断时,应更加关注呼吸症状,并探索 COPD 早期的新疗法和干预措施。