中国疾控中心称,九成中国≥40岁居民为慢阻肺高危人群

2018-06-14 卢芳 中国循环杂志

近日,中国疾病预防控制中心慢性非传染性疾病预防控制中心呼吸病防控室方利文、包鹤龄等对7.5万人进行的研究显示,约90%的中国≥40岁居民为慢性阻塞性肺病(慢阻肺)高危人群,六成高危人群至少暴露一种危险因素。

近日,中国疾病预防控制中心慢性非传染性疾病预防控制中心呼吸病防控室方利文、包鹤龄等对7.5万人进行的研究显示,约90%的中国≥40岁居民为慢性阻塞性肺病(慢阻肺)高危人群,六成高危人群至少暴露一种危险因素。

研究者指出,应该在≥40岁人群中开展慢阻肺筛查,并采取综合防控策略来降低人群危险因素流行水平。

这里符合以下四项条件之一即定义为高危人群:

(1)自报有慢性咳嗽、慢性咳痰、呼吸困难等任一慢性呼吸道症状;

(2)自报有慢性支气管炎、肺气肿等任一慢性呼吸系统疾病史;

(3)有现在或既往吸烟、职业有害因素暴露、儿童期严重呼吸系统感染、室内使用污染燃料等任一危险因素暴露;

(4)有慢性呼吸系统疾病家族史。

研究显示,≥40岁居民中有89.5% 至少符合以上一项条件;至少符合两项、三项和四项的高危人群分别达32%、7.4%和1.5%。

在这九成符合一项条件的高危人群中,研究发现,年龄越大比例越高,而且男性高于女性,乡村高于城镇。

在全国不同地区中,西部和中部是重灾区,符合以上至少一项条件的高危人群分别占93.3%和91.5%,东部地区相对较低占85.6%。

尤其在西部农村中,98.8%的男性属于高危人群。不过,在高危人群比例最低的东部城市女性,占比也高达70.1%。

就慢阻肺危险因素暴露情况,研究显示,94.5%的人有危险因素暴露史,26.9%有家族史,17.2%有呼吸道症状,8.7%有既往疾病史。在高危人群中,只有一项危险因素暴露者高达61.7%。

在各种危险因素中,主要是室内使用污染燃料(68.5%),其次是职业有害因素暴露(52.8%)和吸烟(44.9%)。

其中男性吸烟、慢性咳嗽、慢性咳痰比例明显高于女性,农村室内污染燃料暴露比例明显高于城镇。

慢阻肺的蔓延,据Lancet上报告的中国肺部健康研究,已可比肩糖尿病。该研究显示,我国≥20岁人群中慢阻肺患病率为8.6%,依此估算我国有近1亿慢阻肺患者。而这么多的慢阻肺患者也就仅12%做过肺功能检查。

方利文等指出,通过肺功能检查进行慢阻肺早期诊断和干预对减缓疾病发展非常重要,尤其在高危人群中优先开展肺功能筛查比较合理。

《中国防治慢性病中长期规划(2017-2025)》也提出,要将肺功能检查纳入≥40岁人群常规体检中,并预期在2020年这一群体肺功能检查率达到15%,到2025年达到25%。

此外,方利文等认为,有必要采取措施控制危险因素流行,比如控烟、开展职业卫生教育、在农村地区推广清洁能源烹饪取暖、减少女性室内空气污染暴露水平等。

该研究采用多阶段分层整群随机抽样,共调查了2014-2015年中国31个省市125个COPD监测项目监测点的≥40岁的75107位居民,最终74296位居民纳入分析。研究者对样本进行复杂抽样加权估计高危人群比例及95%CI。

原始出处:
包鹤龄, 丛舒, 王宁, 等. 2014年中国慢性阻塞性肺疾病高危人群现状调查与分析. 中华流行病学杂志, 2018, 39: 580

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    2018-06-16 zutt
  4. [GetPortalCommentsPageByObjectIdResponse(id=1675053, encodeId=7d6616e50536d, content=<a href='/topic/show?id=7d321022504e' target=_blank style='color:#2F92EE;'>#高危人群#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102250, encryptionId=7d321022504e, topicName=高危人群)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e95727161035, createdName=Smile2689, createdTime=Wed Dec 26 14:08:00 CST 2018, time=2018-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2048290, encodeId=3127204829095, content=<a href='/topic/show?id=f8062191152' target=_blank style='color:#2F92EE;'>#中国疾控#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21911, encryptionId=f8062191152, topicName=中国疾控)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c32257, createdName=DEXTER3139, createdTime=Tue Sep 18 06:08:00 CST 2018, time=2018-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405323, encodeId=3ac8140532314, content=<a href='/topic/show?id=3f67e0632c0' target=_blank style='color:#2F92EE;'>#疾控中心#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70632, encryptionId=3f67e0632c0, topicName=疾控中心)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/0AD7956C8522FF8EF9A242DC5569528A/100, createdBy=d51a2536255, createdName=zutt, createdTime=Sat Jun 16 06:08:00 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1530240, encodeId=513615302401b, content=<a href='/topic/show?id=5b3d21912a7' target=_blank style='color:#2F92EE;'>#中国疾控中心#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21912, encryptionId=5b3d21912a7, topicName=中国疾控中心)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fbd912073499, createdName=tcm103hq, createdTime=Sat Jun 16 06:08:00 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324164, encodeId=c1ad324164e4, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Thu Jun 14 15:39:48 CST 2018, time=2018-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324160, encodeId=7d4c32416068, content=现在很多人就是得了慢阻肺也不知道.只知道肺有毛病了.农村人不到万不得已才不求医院看医生呢, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqgHTdZG1XlZlSCxOMafupmK6z0mcEEbtgtUdQ38EPh3iaGkg3czIcz99Iekiaj1xibIrD5hYmmBwDhA/132, createdBy=04872379825, createdName=超人姐姐, createdTime=Thu Jun 14 15:31:01 CST 2018, time=2018-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324159, encodeId=4999324159ed, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqgHTdZG1XlZlSCxOMafupmK6z0mcEEbtgtUdQ38EPh3iaGkg3czIcz99Iekiaj1xibIrD5hYmmBwDhA/132, createdBy=04872379825, createdName=超人姐姐, createdTime=Thu Jun 14 15:29:32 CST 2018, time=2018-06-14, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1675053, encodeId=7d6616e50536d, content=<a href='/topic/show?id=7d321022504e' target=_blank style='color:#2F92EE;'>#高危人群#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102250, encryptionId=7d321022504e, topicName=高危人群)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e95727161035, createdName=Smile2689, createdTime=Wed Dec 26 14:08:00 CST 2018, time=2018-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2048290, encodeId=3127204829095, content=<a href='/topic/show?id=f8062191152' target=_blank style='color:#2F92EE;'>#中国疾控#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21911, encryptionId=f8062191152, topicName=中国疾控)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c32257, createdName=DEXTER3139, createdTime=Tue Sep 18 06:08:00 CST 2018, time=2018-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405323, encodeId=3ac8140532314, content=<a href='/topic/show?id=3f67e0632c0' target=_blank style='color:#2F92EE;'>#疾控中心#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70632, encryptionId=3f67e0632c0, topicName=疾控中心)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/0AD7956C8522FF8EF9A242DC5569528A/100, createdBy=d51a2536255, createdName=zutt, createdTime=Sat Jun 16 06:08:00 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1530240, encodeId=513615302401b, content=<a href='/topic/show?id=5b3d21912a7' target=_blank style='color:#2F92EE;'>#中国疾控中心#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21912, encryptionId=5b3d21912a7, topicName=中国疾控中心)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fbd912073499, createdName=tcm103hq, createdTime=Sat Jun 16 06:08:00 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324164, encodeId=c1ad324164e4, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Thu Jun 14 15:39:48 CST 2018, time=2018-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324160, encodeId=7d4c32416068, content=现在很多人就是得了慢阻肺也不知道.只知道肺有毛病了.农村人不到万不得已才不求医院看医生呢, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqgHTdZG1XlZlSCxOMafupmK6z0mcEEbtgtUdQ38EPh3iaGkg3czIcz99Iekiaj1xibIrD5hYmmBwDhA/132, createdBy=04872379825, createdName=超人姐姐, createdTime=Thu Jun 14 15:31:01 CST 2018, time=2018-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324159, encodeId=4999324159ed, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqgHTdZG1XlZlSCxOMafupmK6z0mcEEbtgtUdQ38EPh3iaGkg3czIcz99Iekiaj1xibIrD5hYmmBwDhA/132, createdBy=04872379825, createdName=超人姐姐, createdTime=Thu Jun 14 15:29:32 CST 2018, time=2018-06-14, status=1, ipAttribution=)]
    2018-06-14 sunfeifeiyang

    0

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    2018-06-14 超人姐姐

    现在很多人就是得了慢阻肺也不知道.只知道肺有毛病了.农村人不到万不得已才不求医院看医生呢

    0

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    2018-06-14 超人姐姐

    不错

    0

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Am J Respir Crit Care Med:非小细胞肺癌对慢阻肺的影响

慢性阻塞性肺疾病(COPD)和非小细胞肺癌(NSCLC)是相互关联的疾病,死亡率高,两者的发病机制均与免疫功能异常相关。免疫检查点抑制剂(ICIS)可阻断PD-1/PD-L1信号,并提高一部分COPD合并NSCLC患者的生存率。

病例分享:慢阻肺急性加重患者综合治疗后胸背部疼痛

患者慢性阻塞性肺疾病明确诊断13年,近2年出现进行性活动耐力下降伴频繁出现的胸背部疼痛。在积极针对慢阻肺急性加重的综合治疗后,患者喘息、气短并无缓解,且胸背部疼痛进行性加重,是反复的急性加重?还是慢阻肺合并其他疾病?在经历系统查体及检查后,最终寻找到「真凶」。

JAHA:慢阻肺患者SAVR和SAVR该如何选择?

慢性阻塞性肺疾病(COPD)患者在心脏手术后发生呼吸相关性并发症的风险更高。目前对于COPD患者,经导管主动脉瓣置换术(TAVR)和外科主动脉瓣置换术(SAVR)哪个预后更佳尚不清楚。本研究纳入了数据库中2011年至2014年年龄≥60岁,接受了TAVR或SAVR治疗的COPD患者,最终共纳入了相互匹配的1210名TAVR患者和1208名SAVR患者。分析结果显示,相比于接受SAVR患者,接受TA

慢阻肺知晓率不足3%,五类高危人群应定期查肺功能

慢病界导读近日,国际权威医学期刊《柳叶刀》发表了由中国工程院院士、中国医学科学院北京协和医学院院校长王辰牵头的中国成人肺部健康研究首项成果。结果显示:我国20岁及以上成人的慢阻肺患病率为8.6%,40岁以上则达13.7%,60岁以上人群患病率超过27%,年龄越高慢阻肺患病率越高。全国总患病人数约1亿。由此可见,慢阻肺已经成为和糖尿病“相当”的慢病。然而,和高患病人数相对应的却是慢阻肺的低知晓率。此

王辰院士:慢阻肺成慢病防控突出短板

4月10日,国际权威医学期刊《柳叶刀》发表我国学者完成的大规模人群研究“中国成人肺部健康研究”的首项成果,揭示了我国慢性阻塞性肺疾病(简称慢阻肺)的流行状况,首次明确我国慢阻肺患者人数约1亿,已经成为与高血压、糖尿病“等量齐观”的慢性疾病,构成重大疾病负担。4月11日,该研究的牵头单位中日友好医院、国家呼吸临床研究中心、首都医科大学呼吸病学系联合举行研究发布会。这项研究首次对我国20岁至40岁年龄

王辰:慢阻肺患病率高知晓率低 成慢病防控突出短板

我国成人慢阻肺患病率超8%,40岁以上逾13%,患病人数约1亿,但知晓率仅为10%,控烟与普及肺功能检查为慢阻肺防控的关键。