中国农村慢性阻塞性肺疾病患病及防治现状  

Current status of prevention and management of chronic obstructive pulmonary disease in rural area in China

作　　者：周玉民[1] 王辰[2] 姚婉贞[3] 陈萍[4] 康健[5] 黄绍光[6] 陈宝元[7] 王长征[8] 倪殿涛[9] 王小平 王大礼[11] 刘升明[1] 吕嘉春[12] 郑劲平[1] 钟南山[1] 冉丕鑫[1] 

机构地区：[1]广州医学院第一附属医院广州呼吸疾病研究所呼吸疾病国家重点实验室,510120 [2]首都医科大学附属北京朝阳医院北京呼吸疾病研究所 [3]北京大学第三医院呼吸内科 [4]沈阳军区总医院呼吸内科 [5]中国医科大学附属第一医院呼吸疾病研究所 [6]上海交通大学医学院附属瑞金医院呼吸内科 [7]天津医科大学总医院呼吸内科 [8]第三军医大学新桥医院呼吸内科 [9]第四军医大学西京医院呼吸内科 [10]广东韶关市第一人民医院呼吸内科 [11]广州市荔湾区第二人民医院呼吸内科 [12]广州医学院公共卫生与全科医学学院

出　　处：《中华内科杂志》2009年第5期358-361,共4页Chinese Journal of Internal Medicine

基　　金：国家“十五”攻关课题[2001BA703803（A）];广东省“十五”重点支持项目（B30301）

摘　　要：目的了解中国农村慢性阻塞性肺疾病（COPD）患病及防治现况。方法全国的横断面调查。在中国7个省市（北京市、上海市、广东省、辽宁省、天津市、重庆市和陕西省）的农村地区，采用多阶段整群随机抽样方法，在每个地区抽取1个农村镇作为调查点，对年龄≥40岁的人群进行问卷调查和肺功能检测。对[第1秒钟用力呼气容积（FEV1）／用力肺活量（FVC）]×100％〈70％者，进行支气管舒张试验。以支气管舒张试验后（FEV1／FVC）×100％〈70％作为COPD的诊断标准。结果（1）有效调查人数为9434人，有效应答率为83．6％，COPD患病率为8．8％，男、女患病率分别为12．8％、5．4％。（2）中国农村地区的吸烟率和生物燃料暴露率高，分别为43．0％、83．1％；戒烟率低（17．5％），只有12．4％的吸烟者接受过戒烟劝导。（3）COPD患者中，只有30．0％的患者曾经诊断过COPD相关的呼吸系统疾病，2．4％的患者曾经检测过肺功能；COPD患者目前吸烟比例高达74．5％，Ⅱ级及Ⅱ级以上COPD患者中，只有7．9％的患者规则用药。结论中国农村COPD患病率高，防治状况差，迫切需要加强COPD人群防治。Objective To investigate the current status of prevalence, prevention and management of chronic obstructive pulmonary disease（COPD） in rural area in China. Methods A cross-sectional survey of COPD was conducted in Beijing city, Shanghai city, Guangdong province, Liaoning province, Tianjin city, Chongqing province and Shanxi province. A population-based cluster sample was randomly selected from each rural area. In the selected community, all residents at least 40 years old were recruited, and interviewed with a modified standardized questionnaire from the international burden of obstructive lung diseases （ BOLD ） study. All participants were tested with spirometry. Those with airflow limitation were performed on postbronchodilator spirometry. The post-bronchodilator a ratio of forced expiratory volume in one second to forced vital capacity （FEVI/FVC） less than 70% was defined as the diagnostic criteria of COPD. Results （1） Data of 9434 participants was valid for analysis, with a valid response rate of 83.6% ;the prevalence of COPD in rural was 8. 8% （830/9434）, 12. 8% in male and 5.4% in female. （2） The percentage of smoking and the exposure to biomass smoke in rural was 43.0% （4059/9434） and 83.1% （7835/9434） respectively ; eigarettes cessation rate was 17.5% ; only 12. 4% （502/4059） of smokers had received advice to quit smoking. （3） Among COPD patients, only 30. 0% （249/830） had ever been diagnosed as COPD, bronchitis, emphysema, or asthma, 2. 4% （20/830） had ever received spirometrie tests, and 74. 5% were current smokers; only 7. 9% （50/634） COPD patients in stage two or over had received regular drug treatment. Conclusion There was high prevalence and poor prevention and management for COPD in rural areas. Therefore, an enforced prevention and management for COPD are urgent.

关 键 词：肺疾病 慢性阻塞性 流行病学 患病率 

分 类 号：R686[医药卫生—骨科学]