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目的了解北京市农村地区无症状慢性阻塞性肺疾病(COPD)患者的流行病学特点。方法对北京市延庆县5个自然村40岁以上1624名进行入户调查。进行问诊、体检,填写流行病学调查问卷并进行肺功能检查。结果该地区40岁以上COPD患者148例,总患病率为9.1%(148/1624),其中无症状组62例(42%),有症状组86例(58%);无症状COPD的患病率为3.8%(62/1624)。无症状组和有症状组患者性别、年龄、职业、婚姻状况、受教育程度和吸烟情况比较差异均无统计学意义(P均>0.05)。肺功能检测显示,有症状组第一秒用力呼气容积(FEV1)、第一秒用力呼气容积占预计值百分比(FEV1占预计值%)为(1.3±0.7)L、(61±23)%,与无症状组[(1.5±0.6)L、(70±22)%]比较,差异均有统计学意义(P均<0.05)。结论COPD在该地区患病率较高,其中无症状COPD的比例也较高。由于COPD的诊断需要依靠肺功能测定,而早期肺功能受损不太严重时临床症状不明显,因而造成COPD的漏诊和对疾病危害的低估。
Objective To understand the epidemiological characteristics of asymptomatic chronic obstructive pulmonary disease (COPD) in rural Beijing. Methods A total of 1624 people over 40 years old from 5 villages in Yanqing County, Beijing were investigated. Conduct interrogation, physical examination, fill in the epidemiological questionnaire and pulmonary function tests. Results 148 cases of COPD were over 40 years old in the area, with a total prevalence rate of 9.1% (148/1624), of which 62 (42%) were asymptomatic and 86 (58%) were symptomatic; in asymptomatic COPD The prevalence was 3.8% (62/1624). There was no significant difference in sex, age, occupation, marital status, education level and smoking between asymptomatic and symptomatic groups (all P> 0.05). Pulmonary function tests showed that the first second forced expiratory volume (FEV1) and the forced expiratory volume in the first second were (1.3 ± 0.7) L and (61 ± 23)% respectively of the predicted value (% of predicted value of FEV1) %, Compared with asymptomatic group [(1.5 ± 0.6) L, (70 ± 22)%], the difference was statistically significant (all P <0.05). Conclusion The prevalence of COPD in the area is high, and the proportion of asymptomatic COPD is also high. Because the diagnosis of COPD depends on the determination of pulmonary function, clinical symptoms are not obvious when the impairment of early pulmonary function is not serious, resulting in missed diagnosis of COPD and underestimation of the disease.