2014－2015年中国40岁及以上慢性阻塞性肺疾病患者肺功能检查率及其影响因素分析

吕学莉; 丛舒; 樊静; 张阳; 王宁; 包鹤龄; 王宝华; 王前; 王临虹; 方利文

文章摘要

吕学莉,丛舒,樊静,张阳,王宁,包鹤龄,王宝华,王前,王临虹,方利文.2014－2015年中国40岁及以上慢性阻塞性肺疾病患者肺功能检查率及其影响因素分析[J].中华流行病学杂志,2020,41(5):672-677

2014－2015年中国40岁及以上慢性阻塞性肺疾病患者肺功能检查率及其影响因素分析

Analyses of the rate of spirometry examination and its related factors in chronic obstructive pulmonary diseasepatients aged 40 years or older in China, 2014-2015

收稿日期:2020-01-22 出版日期:2020-05-12

DOI：10.3760/cma.j.cn112338-20200122-00054

中文关键词: 肺功能检查慢性阻塞性肺疾病横断面研究监测

英文关键词: Spirometry Chronic obstructive pulmonary disease Cross-sectional study Surveillance

基金项目:国家重点研发计划（2016YFC1303905，2016YFC1303900）；中央财政转移支付重大公共卫生项目

作者	单位	E-mail
吕学莉	中国疾病预防控制中心慢性非传染性疾病预防控制中心, 北京 100050
丛舒	中国疾病预防控制中心慢性非传染性疾病预防控制中心, 北京 100050
樊静	中国疾病预防控制中心慢性非传染性疾病预防控制中心, 北京 100050
张阳	中国疾病预防控制中心慢性非传染性疾病预防控制中心, 北京 100050
王宁	中国疾病预防控制中心慢性非传染性疾病预防控制中心, 北京 100050
包鹤龄	中国疾病预防控制中心慢性非传染性疾病预防控制中心, 北京 100050
王宝华	中国疾病预防控制中心慢性非传染性疾病预防控制中心, 北京 100050
王前	中国疾病预防控制中心慢性非传染性疾病预防控制中心, 北京 100050
王临虹	中国疾病预防控制中心慢性非传染性疾病预防控制中心, 北京 100050
方利文	中国疾病预防控制中心慢性非传染性疾病预防控制中心, 北京 100050	fangliwen@ncncd.chinacdc.cn

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中文摘要:

目的了解2014-2015年我国≥ 40岁慢性阻塞性肺疾病（慢阻肺）患者的肺功能检查率及其影响因素，为慢阻肺患者规范化诊断、治疗和管理提供依据。方法数据来源于2014-2015年中国居民慢阻肺监测。采用面对面调查的方法收集调查对象既往肺功能检查状况等信息。通过肺功能检查将吸入支气管舒张剂后FEV₁/FVC<70%者诊断为慢阻肺患者，共纳入9 130名慢阻肺患者。经复杂抽样加权后，估计≥ 40岁慢阻肺患者肺功能检查率及其95% CI，并分析其影响因素。结果我国≥ 40岁慢阻肺患者肺功能检查率为5.9%（95% CI：4.9%~6.9%），男性为6.1%（95% CI：5.2%~7.1%），女性为5.3%（95% CI：4.0%~6.6%），城镇高于乡村（P<0.001），且随患者文化程度升高而增加（P<0.001）。务农慢阻肺患者肺功能检查率最低为4.0%（95% CI：3.1%~4.9%）。知晓肺功能检查的患者肺功能检查率为32.3%（95% CI：26.4%~38.1%）。有既往慢性呼吸系统疾病史和有呼吸道症状的患者肺功能检查率分别为13.7%（95% CI：11.5%~15.9%）和8.8%（95% CI：7.2%~10.4%）。有职业粉尘和/或有害气体暴露的慢阻肺患者肺功能检查率为5.7%（95% CI：4.6%~6.9%）。曾经吸烟的患者肺功能检查率为10.2%（95% CI：8.0%~12.4%），均高于现在吸烟者（4.2%，95% CI：3.3%~5.1%）和从不吸烟者（6.3%，95% CI：5.1%~7.6%）。结论我国≥ 40岁慢阻肺患者肺功能检查水平很低，慢阻肺患者规范化诊断、治疗和管理水平亟待提高。

英文摘要:

Objective To understand the rate of spirometry examination and its related factors among chronic obstructive pulmonary disease (COPD) patients aged ≥ 40 years in China from 2014 to 2015, and provide evidence for diagnosis, treatment and management of COPD patients normatively. Methods Data were obtained from 2014-2015 COPD surveillance, China. The previous lung function examination status and other information of the subjects were collected by face-to-face survey. We defined COPD as a post-bronchodilator FEV₁:FVC less than 70%. A total of 9 130 COPD patients were included in the analysis of this study. The rate of spirometry examination and its 95% confidence interval (CI) were estimated in COPD patients aged ≥ 40 years with complicated sampling weights. Meanwhile, the spirometry examination related factors were analyzed. Results The estimated rate of spirometry examination among COPD patients was 5.9% (95%CI:4.9%-6.9%), 6.1% (95%CI:5.2%-7.1%) for men and 5.3% (95%CI:4.0%-6.6%) for women. The rate was significantly higher in urban population than in rural (P<0.001). With the increase of education level, the rate of spirometry examination among COPD patients increased gradually (P<0.001). The rate of spirometry examination was 4.0% (95%CI:3.1%-4.9%) among COPD patients in agricultural industry. The rate of spirometry examination among COPD patients with awareness of pulmonary function test was 32.3% (95%CI:26.4%-38.1%). The rate of spirometry examination among COPD patients with previous chronic respiratory disease and respiratory symptoms were 13.7%(95%CI:11.5%-15.9%), 8.8%(95%CI:7.2%-10.4%), respectively. The rate of spirometry examination among COPD patients exposed to occupational dust and/or harmful gases was 5.7% (95%CI:4.6%-6.9%). The rate of spirometry examination in former smokers among COPD patients was 10.2% (95%CI:8.0%-12.4%), higher than those in current smokers (4.2%, 95%CI:3.3%-5.1%) and non-smokers (6.3%, 95%CI:5.1%-7.6%). Conclusion The rate of spirometry examination is extremely low among COPD patients aged ≥ 40 in China, and the standardized diagnosis, treatment and management of COPD patients need to be improved urgently.

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