[Lancet在线发表]:中国的COPD患病率及危险因素:一项全国横断面研究 | 中国病理生理学会危重病医学专业委员会
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2018年04月15日 时讯速递, 进展交流 暂无评论


Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study

Chen Wang, Jianying Xu, Lan Yang, et al

Lancet 2018 Available online 9 April 2018


Background 背景

Although exposure to cigarette smoking and air pollution is common, the current prevalence of chronic obstructive pulmonary disease (COPD) is unknown in the Chinese adult population. We conducted the China Pulmonary Health (CPH) study to assess the prevalence and risk factors of COPD in China.


Methods 方法

The CPH study is a cross-sectional study in a nationally representative sample of adults aged 20 years or older from ten provinces, autonomous regions, and municipalities in mainland China. All participants underwent a post-bronchodilator pulmonary function test. COPD was diagnosed according to 2017 Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria.


Findings 结果

Between June, 2012, and May, 2015, 57 779 individuals were invited to participate, of whom 50 991 (21 446 men and 29 545 women) had reliable post-bronchodilator results and were included in the final analysis. The overall prevalence of spirometry-defined COPD was 8·6% (95% CI 7·5–9·9), accounting for 99·9 (95% CI 76·3–135·7) million people with COPD in China. Prevalence was higher in men (11·9%, 95% CI 10·2–13·8) than in women (5·4%, 4·6–6·2; p<0·0001 for sex difference) and in people aged 40 years or older (13·7%, 12·1–15·5) than in those aged 20–39 years (2·1%, 1·4–3·2; p<0·0001 for age difference). Only 12·0% (95% CI 8·1–17·4) of people with COPD reported a previous pulmonary function test. Risk factors for COPD included smoking exposure of 20 pack-years or more (odds ratio [OR] 1·95, 95% CI 1·53–2·47), exposure to annual mean particulate matter with a diameter less than 2·5 μm of 50–74 μg/m3 (1·85, 1·23–2·77) or 75 μg/m3 or higher (2·00, 1·36–2·92), underweight (body-mass index <18·5 kg/m2; 1·43, 1·03–1·97), sometimes childhood chronic cough (1·48, 1·14–1·93) or frequent cough (2·57, 2·01–3·29), and parental history of respiratory diseases (1·40, 1·23–1·60). A lower risk of COPD was associated with middle or high school education (OR 0·76, 95% CI 0·64–0·90) and college or higher education (0·47, 0·33–0·66).

2012年6月至2015年5月间,共有57779人受邀参加研究,其中50991人(21446名男性,29545名女性)有可靠的支气管扩张剂后检查结果,因而纳入最终分析。经肺量计诊断的COPD患病率为8·6% (95% CI 7·5–9·9),相当于全国 99·9 (95% CI 76·3–135·7) 百万人罹患 COPD。男性患病率 (11·9%, 95% CI 10·2–13·8) 高于女性 (5·4%, 4·6–6·2; 性别差异 p<0·0001 ),40岁以上人群患病率 (13·7%, 12·1–15·5) 超过 20–39 岁人群 (2·1%, 1·4–3·2; 年龄差异 p<0·0001)。仅有 12·0% (95% CI 8·1–17·4) 的COPD患者既往接受过肺功能检查。COPD的危险因素包括吸烟超过20 包年 (比数比 [OR] 1·95, 95% CI 1·53–2·47),年平均PM 2.5为50–74 μg/m3 (1·85, 1·23–2·77) 或 75 μg/m3 以上 (2·00, 1·36–2·92),体重不足 (BMI <18·5 kg/m2; 1·43, 1·03–1·97),儿童期偶尔慢性咳嗽 (1·48, 1·14–1·93) 或经常咳嗽 (2·57, 2·01–3·29),以及父母呼吸疾病病史 (1·40, 1·23–1·60)。COPD的低危因素包括初中或高中教育背景 (OR 0·76, 95% CI 0·64–0·90) 及大学以上教育背景 (0·47, 0·33–0·66)。

Interpretation 结论

Spirometry-defined COPD is highly prevalent in the Chinese adult population. Cigarette smoking, ambient air pollution, underweight, childhood chronic cough, parental history of respiratory diseases, and low education are major risk factors for COPD. Prevention and early detection of COPD using spirometry should be a public health priority in China to reduce COPD-related morbidity and mortality.



Ministry of Health and Ministry of Science and Technology of China.


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