中国人群主动吸烟与慢性阻塞性肺病关系的Meta分析  

A meta-analysis of the relationship between active smoking and chronic obstructive pulmonary disease in Chinese population

作　　者：杨文怡 王敬鑫 艾丽梅 赵健 石钰霖 王宇彤 艾飞玲 王雪威 胡葵如 万霞[1] YANG Wen-yi;WANG Jing-xin;AI Li-mei;ZHAO Jian;SHI Yu-lin;WANG Yu-tong;AI Fei-lin;WANG Xue-wei;HU Kui-ru;WAN Xia(Institute of Basic Medical Sciences,Chinese Academy of Medical Science&School of Basic Medicine,Peking Union Medical College,Beijing 100005,China)

机构地区：[1]中国医学科学院基础医学研究所,北京协和医学院基础学院,北京100005

出　　处：《现代预防医学》2022年第22期4064-4070,4084,共8页Modern Preventive Medicine

基　　金：中国医学科学院协同创新团队项目“基于队列的环境因素和消化道微生态变化对我国消化系统相关疾病健康效应研究”(2016-12M-3-001);美国中华医学基金会(China Medical Board)项目“Strengthen Capacity of Study and Application on Burden of Disease in Health Care System of China–Establishment and Development of Chinese Burden of Disease Research and Dissemination Center”(15-208)。

摘　　要：目的通过meta分析探究中国人群慢性阻塞性肺病(COPD)的危险因素,为制定中国控烟政策及评估中国烟草带来的疾病负担提供必要的参数。方法在Pub Med、Web of science、Embase、中国知网、维普、万方数据库中检索从建库至2021年6月31日发表的所有吸烟相关疾病的中、英文队列或病例对照研究文献,筛选并提取相关信息。使用Stata16.0进行meta分析,探究吸烟与慢性阻塞性肺病发病/死亡的关联。结果最终纳入16篇文献,其中队列研究10篇,病例对照6篇。Meta分析结果显示,吸烟是COPD的重要危险因素,曾吸烟者较不吸烟者COPD患病/死亡风险更大,RR值为2.64(95%CI:1.74~4.00),其中男性RR为1.74(95%CI:1.44~2.09),女性RR为4.06(95%CI:2.53~6.52),女性显著高于男性。亚组分析结果显示,除男性曾吸烟者病例对照研究(RR:2.22,95%CI:1.68~2.95)和队列研究(RR:1.33,95%CI:1.19~1.49)RR可信区间无交叠,差异有统计学意义外,其他不同类别的各亚组间RR值差异没有统计学意义。结论虽然与西方国家相比,中国人群RR值偏低,但吸烟仍是COPD的重要危险因素,其中女性较男性危险度更高。为减轻COPD造成的疾病负担,应进一步加强控烟相关措施。同时,作为一篇只针对于中国人群的研究,本篇文献将为制定中国控烟政策及评估中国烟草带来的疾病负担提供相关依据。Objective To explore the risk factors of chronic obstructive pulmonary disease(COPD)in Chinese population through meta-analysis,and to provide necessary parameters for the formulation of tobacco control policies and the assessment of disease burden caused by smoking in China.Methods The literature of all Chinese and English cohort or case-control studies on smoking-related diseases published from the establishment of the database to June 31,2021 were retrieved from PubMed,Web of Science,Embase,CNKI,VIP,and Wanfang databases,and the relevant information was screened and extracted.A meta-analysis was performed using Stata16.0 to investigate the association between smoking and morbidity/mortality from chronic obstructive pulmonary disease.Results Sixteen articles including 10 cohort studies and 6 case control studies were identified.Meta-analysis results showed that former smokers had a higher risk of COPD disease/death than nonsmokers,with a relative risk(RR)of 2.64(95%CI:1.74-4.00)for both population and 1.74(95%CI:1.44-2.09)for males.RR value for females was 4.06(95%CI:2.53-6.52),which was significantly higher than males.The results of subgroup analysis showed except the statistically significant differences found for male former smokers in case-control study(RR=2.22,95%CI:1.68-2.95)and cohort study(RR=1.33,95%CI:1.19-1.49),no significant differences were observed for subgroups of other categories.Conclusion Although the RR values are lower in the Chinese population than in western countries,smoking remains an important risk factor for COPD,with women at higher risk than men.To reduce the disease burden caused by COPD,measures related to tobacco control should be further strengthened.At the same time,as a study only focused on the Chinese population,this paper will provide relevant basis for the formulation of tobacco control policies in China and the assessment of the disease burden caused by tobacco in China.

关 键 词：中国人群 吸烟 COPD 危险因素 META分析 

分 类 号：R563.9[医药卫生—呼吸系统]