| 张阳,王宁,樊静,丛舒,吕学莉,王宝华,包鹤龄,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药物治疗率及其影响因素分析[J].中华流行病学杂志,2020,41(5):678-684 |
| 2014－2015年中国40岁及以上慢性阻塞性肺疾病患者药物治疗率及其影响因素分析 |
| Analysis in medication treatment and its related factors among patients with chronic obstructive pulmonary disease aged 40 years or older in China, 2014-2015 |
| 收稿日期:2020-01-31 出版日期:2020-05-12 |
| DOI：10.3760/cma.j.cn112338-20200131-00060 |
| 中文关键词: 慢性阻塞性肺疾病 药物 治疗 |
| 英文关键词: Chronic obstructive pulmonary disease Medication Treatment |
| 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 |
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| 中文摘要: |
| 目的 了解中国≥ 40岁慢性阻塞性肺疾病（慢阻肺）患者的药物治疗率及其影响因素，为有针对性地开展干预，提高慢阻肺患者诊断治疗水平提供基础数据。方法 数据来源于2014-2015年中国居民慢阻肺监测。对所有调查对象进行问卷调查和支气管舒张试验前后肺功能检测，将支气管舒张试验后FEV1/FVC<70%者诊断为慢阻肺。共9 120名慢阻肺患者纳入分析。基于复杂抽样设计估计慢阻肺患者药物治疗率及其95% CI，并分析其影响因素。结果 ≥ 40岁慢阻肺患者的药物治疗率为11.7%（95% CI：10.2%~13.0%），吸入药物治疗率为3.4%（95% CI：2.9%~4.0%），口服或静脉药物治疗率为10.4%（95% CI：9.0%~12.0%），调查前知晓自己患有慢阻肺者的药物治疗率最高。≥ 60岁患者的药物治疗率高于<60岁者。女性药物治疗率、口服或静脉药物治疗率均高于男性，有职业有害因素暴露者这2个治疗率高于无暴露者，曾经吸烟者的药物治疗率、口服或静脉药物治疗率高于现在吸烟者和从不吸烟者。调查前知晓自己患有慢阻肺者的治疗率均高于不知晓者，有呼吸道症状者的治疗率均高于无症状者。结论 中国≥ 40岁慢阻肺患者药物治疗率，特别是吸入药物治疗率很低，了解自己慢阻肺患病状况、出现呼吸道症状是影响慢阻肺药物治疗的重要因素。应加强慢阻肺早期诊断，提高患者规范化治疗水平。 |
| 英文摘要: |
| Objective To understand the medication treatment rate and its associated factors among chronic obstructive pulmonary disease (COPD) patients aged ≥ 40 years in China, and to provide basic data for targeted interventions to improve the diagnosis and treatment of COPD patients. Methods Data were from COPD surveillance of Chinese residents in 2014-2015. Questionnaire and pre-bronchodilator and post-bronchodilator spirometry were performed on all respondents. Individuals with post-bronchodilator FEV1/FVC<70% were diagnosed as COPD patients. A total of 9 120 COPD patients were included in the analysis. Based on the complex sampling design, the medication treatment rate and 95%CI among COPD patients were estimated, and the associated factors were analyzed. Results The medication treatment rate for COPD patients aged ≥ 40 years was 11.7% (95%CI:10.2%-13.0%), the treatment rate with inhaled medication was 3.4% (95%CI:2.9%-4.0%), and the treatment rate with oral or intravenous medication was 10.4% (95%CI:9.0%-12.0%). All treatment rates were higher in patients who knew that they had COPD before the investigation. The rate of medication treatment in patients aged ≥ 60 years was higher than that in patients aged <60 years. Medication treatment rate, and oral or intravenous medication treatment rate among women were higher than those among men. These two treatment rates in patients with harmful occupational exposure were higher than those in patients without exposure. The medication treatment rate, and oral or intravenous medication treatment rate in former smokers were higher than those in current smokers and never smokers. Patients who knew that they had COPD before the investigation had higher rates of three treatments than those who were not aware of their disease conditions. Those with respiratory symptoms had higher three treatments rates than those without symptoms. Conclusion In China, the rate of medication treatment for COPD patients aged ≥ 40 years old, especially the rate of inhaled medication treatment was very low. Being aware of their own COPD status and the emergence of respiratory symptoms were important factors associated with COPD medication treatment. Early diagnosis of COPD should be strengthened and the level of standardized treatment for patients should be improved. |
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