2014年中国慢性阻塞性肺疾病高危人群现状调查与分析

包鹤龄; 丛舒; 王宁; 樊静; 冯雅靖; 王宝华; 王临虹; 方利文

文章摘要

包鹤龄,丛舒,王宁,樊静,冯雅靖,王宝华,王临虹,方利文.2014年中国慢性阻塞性肺疾病高危人群现状调查与分析[J].中华流行病学杂志,2018,39(5):580-585

2014年中国慢性阻塞性肺疾病高危人群现状调查与分析

Survey and analyses of population at high risk of chronic obstructive pulmonary disease in China, 2014

收稿日期:2017-12-16 出版日期:2018-05-24

DOI：10.3760/cma.j.issn.0254-6450.2018.05.008

中文关键词: 慢性阻塞性肺疾病人群筛查肺功能检查横断面研究

英文关键词: Chronic obstructive pulmonary disease Mass screening Spirometry examination Cross-sectional study

基金项目:中央转移支付重大公共卫生项目；国家重点研发计划（2016YFC1303905）

作者	单位	E-mail
包鹤龄	100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心呼吸病防控室
丛舒	100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心呼吸病防控室
王宁	100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心呼吸病防控室
樊静	100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心呼吸病防控室
冯雅靖	100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心呼吸病防控室
王宝华	100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心呼吸病防控室
王临虹	100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心呼吸病防控室
方利文	100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心呼吸病防控室	fangliwen@ncncd.chinacdc.cn

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中文摘要:

目的了解中国≥40岁居民中COPD高危人群的分布和特征，为COPD综合防控提供依据。方法对象来源于2014－2015年中国居民COPD监测项目中内地31个省（自治区、直辖市），采用多阶段分层整群随机抽样，共调查125个监测点的≥40岁研究对象75 107名。采用面对面询问调查方式收集相关信息，符合四项条件之一者定义为高危人群：慢性呼吸道症状、危险因素暴露史、慢性呼吸系统疾病史、家族史。对样本进行复杂抽样加权估计高危人群比例以及95% CI。结果 74 296名调查对象纳入分析，至少符合一项条件的COPD高危人群比例为89.5%（95% CI：87.8%～91.2%），且随年龄增大比例增加（P<0.001）；男性高于女性（P<0.001）、乡村高于城镇（P<0.001）；西部农村男性中高危人群比例最高（98.8%，95% CI：98.0%～99.6%）。至少符合两项条件、三项条件和四项条件的高危人群占总人数的比例分别为32.0%（95% CI：29.7%～34.2%）、7.4%（95% CI：6.6%～8.3%）和1.5%（95% CI：1.2%～1.8%）。在高危人群中只有一项危险因素暴露者所占比重最大（61.7%，95% CI：59.8%～63.7%）。结论中国≥40岁居民中COPD高危人群近九成，应在该人群中开展COPD筛查，采取综合防控策略降低人群危险因素流行水平。

英文摘要:

Objective To understand the distribution and characteristics of people aged ≥ 40 years who are at high risk of COPD in China and provide evidence for COPD prevention and control. Methods The survey was conducted among the subjects selected through multi-stage stratified cluster sampling from 31 provinces (autonomous regions and municipalities) in China for 2014-2015 national chronic obstructive pulmonary disease surveillance. A total of 75 107 people aged ≥ 40 years in 125 surveillance points were surveyed in face to face interviews. Subjects who met at least one of the following conditions, including chronic respiratory symptoms, exposure to risk factors, medical history of respiratory diseases, and family history, were defined as population at high risk. The weighted proportion of the population at high risk of COPD and 95% CI were estimated by using complex sampling design. Results Among eligible 74 296 subjects, the proportion of population at high risk of COPD was 89.5% (95% CI:87.8%-91.2%). The proportion significantly increased with age (P<0.001). The proportion of the population at high risk was significantly higher in men than in women (P<0.001), and in rural area than in urban area (P<0.001). The highest proportion of population at high risk was observed in men in rural area in western China. The proportion of population at high risk of COPD who met at least two conditions was 32.0% (95% CI:29.7%-34.2%), the proportion of those who met at least three conditions was 7.4% (95% CI:6.6%-8.3%), and the proportion of those who met all the conditions was 1.5% (95% CI:1.2%-1.8%). Among population at high risk of COPD, those who only had exposure to one risk factor accounted for 61.7% (95% CI:59.8%-63.7%). Conclusion About 90% of people aged ≥ 40 years in China are at high risk for COPD. It is necessary to conduct population-based screening for COPD and take comprehensive measures to reduce prevalence of risk factors.

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