摘要
目的:研究北京石景山区40岁及以上居民慢性阻塞性肺疾病（COPD）的患病情况及相关危险因素。方法:2019年6月至12月采用随机抽样方法对北京石景山区10个社区40岁及以上居民进行监测。对研究对象进行问卷调查和身体测量，所有研究对象均进行吸入支气管舒张药物前、后肺功能检查以调查COPD患病情况及相关危险因素。结果:共有4096名监测对象具有可靠的药后肺功能结果并被纳入最终研究，其中男性1886名（46.0%），女性2210名（54.0%）。总体患病率为10.2%，男性为13.8%，高于女性的7.1%，并且随着年龄的增加COPD患病率亦升高。在诊断的COPD患者中，49.8%的患者为中-重度阻塞（GOLD分级Ⅱ~Ⅳ级），37.5%的人群做过肺功能检查，12.5%了解自己曾诊断COPD。吸烟是COPD的主要危险因素（OR=1.94，95%CI：1.45~2.58，P＜0.05），COPD的患病率与吸烟包年数呈正相关，仍有已知自己为COPD的患者未戒烟。其他的危险因素包括男性（OR=1.52，95%CI：1.22~2.05，P＜0.05）、年龄增加（OR=1.66，95%CI：1.34~2.41，P＜0.05）、呼吸道疾病家族史（OR=1.73，95%CI：1.33~2.23，P＜0.05），幼时支气管炎/肺炎病史（OR=2.035，95%CI：1.339～3.095，P＜0.05）。结论:北京石景山区40岁及以上居民COPD患病率较高。目前需要制定针对疾病预防、早期诊断、疾病管理的策略以降低COPD疾病负担。
Abstract
Objective:To investigate the prevalence and risk factors of chronic obstructive pulmonary disease (COPD) in residents aged 40 years and above in Shijingshan district of Beijing.Methods:The residents aged 40 years and above in 10 communities of Shijingshan district of Beijing were included by random sampling method from June to December 2019. Questionnaire survery, physical measurement, pulmonary function examination before and after bronchodilator treatment were conducted on all the subjects. COPD was diagnosed based on the 2020 Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. The prevalence of COPD and related risk factors were investigated in those subjects.Results:A total of 4 096 participants had reliable post-bronchodilator results and were included in the final analysis, including 1 886 males (46.0%) and 2 210 females (54.0%). The overall prevalence of COPD was 10.2%, and it was higher in men (13.8%) than in women (7.1%). The prevalence of COPD increased with age. Among adults with COPD, 49.8% (95%) had moderate or severe disease (GOLD stageⅡ-Ⅳ), 37.5% reported that they had a previous pulmonary function test, and 12.5% knew their diagnosis of COPD. Smoking was the main risk factor for COPD (odds ratio [OR]=1.94,95% confidence interval [CI]:1.45-2.58, P＜0.05). The prevalence of COPD was positively related to the pack-years of smoking. Certain COPD patients had not quit smoking although they knew that they had COPD. Other risk factors for COPD included male gender (OR=1.52, 95%CI: 1.22-2.05, P＜0.05), older age (OR=1.66, 95%CI: 1.34-2.41, P＜0.05), family history of lung disease (OR=1.73, 95%CI: 1.33-2.23, P＜0.05), and history of bronchitis/pneumonia in childhood (OR=2.035, 95%CI: 1.339-3.095, P＜0.05).Conclusions:The prevalence of COPD in Shijingshan residents aged 40 and above is high. Strategies for prevention, early diagnosis, and management of COPD are urgently needed to reduce COPD-related burden.
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