北京市农村地区慢性肺源性心脏病流行病学调查结果及分析  

Epidemiological data of chronic cor pulmonale in patients with chronic obstructive pulmonary disease in Yanqing County,Beijing

作　　者：朱红[1] 姚婉贞[1] 沈宁[1] 梁岩静[1] 周庆涛[1] 张立强[1] 赵鸣武[1] 

机构地区：[1]北京大学第三医院呼吸科,北京100083

出　　处：《中国呼吸与危重监护杂志》2007年第6期419-423,共5页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：国家"十五"科技攻关项目(2001BA703B03)

摘　　要：目的了解北京市农村地区慢性肺源性心脏病(简称肺心病)的患病率及其易患因素。方法对北京市延庆县5个自然村40岁以上1624人进行入户问卷调查。通过问诊、体检及肺功能检查筛选出慢性阻塞性肺疾病(COPD)患者。对所有COPD患者进行X线正位胸片、12导联心电图检查。肺心病诊断采用1977年全国肺心病会议诊断标准。对肺心病发生的可能影响因素进行分析。结果该地区检出COPD患者148例,总患病率为9.11%,其中男性为15.05%,女性为3.76%。148例患者中有139例进行了心电图检查,137例进行了X线胸片检查,通过心电图标准诊断肺心病21例,X线标准诊断4例,同时符合X线和心电图诊断标准的3例,共诊断肺心病28例。肺心病在COPD患者中的发生率为18.92%,占40岁以上人口的1.72%。肺心病患者的平均年龄为(55.12±11.84)岁,男25例,女3例。26例患者肺心病处于心功能代偿期,2例患者有右心功能不全表现。研究显示,随着年龄的增加肺心病在调查人群中的发病率增加。最高年龄组为70～79岁,肺心病患病率达到55.24‰。COPD患者大多数肺功能为Ⅰ级～Ⅲ级,以肺功能Ⅳ级发生肺心病的比率最高(33.33%)。在无咳嗽、咳痰、呼吸困难等呼吸道症状的COPD患者中肺心病的发病率明显小于有呼吸道症状的COPD患者(P<0.01)。但在有症状COPD组肺心病的发病率与咳嗽、咳痰病程长短无明显相关。结论北京农村地区COPD患病率高,致使肺心病的发病率增加,严重危害人民健康。制定有效的防治策略,减少COPD的发病率,减缓COPD肺功能的下降,是预防肺心病发生的关键。Objective To evaluate the prevalence and risk factors of chronic cor pulmonale in a rural area of Beijing. Methods The data of 1 624 people aged more than 40 in 5 villages in Yanqing County, Beijing were collected. The living condition and habit were recorded,and physical examinations and lung function tests were performed. Chronic cor pulmonale was diagnosed according to the national criteria by chest radiography and electrocardiography. Results The prevalenee of chronic obstructive pulmonary disease（COPD） was 9. 11% in this area, 15.05% in males and 3. 76% in females. Twenty-eight patients were diagnosed as chronic cor pulmonale,which accounted for 18.92% of the patients with COPD and for 1.72% of the population ≥40 year old in this area. Cor pulmonale was diagnosed by electrocardiography in 21 patients, by chest radiography in 4, and by both in 3. The average age of the patients with cor pulmonale was 55.12 year. The heart function was compensated in 26 patients, but decompensated in 2 patients. The morbidity of cor pulmonale was increased with age and the decline of FEV1 ,and significantly inereased in the symptomatie group as compared to the non-symptomatic group（ P 〈0. 01 ）, Conclusions The prevalence of COPD and cor pulmonale was high in the rural area of Beijing. COPD is a major public health problem and the major cause of cor pulmonale. Decline of lung function is a significant influencing factor for cor pulmonale. Intervention of decline of lung function is an important measure for preventing cor pulmonale.

关 键 词：慢性阻塞性肺疾病 慢性肺源性心脏病 流行病学调查 

分 类 号：R541.5[医药卫生—心血管疾病]