摘要目的 探讨宁波地区慢性阻塞性肺疾病(COPD)患病率及诊治情况.方法 2012年7月至2015年6月采用多级分层随机抽样方法,从宁波11个县区中随机抽取7个县区,从该7个县区中随机抽取8个生活小区和3个自然村中年龄≥40岁自愿接受调查的5865人进行调查.通过肺功能筛查、呼吸道症状和诊治情况问卷调查,应用SPSS 17.0统计软件来分析该地区COPD的患病情况和诊治现状,探讨加强宁波地区COPD早期防治的重要意义.完成合格问卷调查及肺功能检测者5674人,符合纳入标准者5674人.其中,男性3044人(53.6%),平均年龄(55.7±11.4)岁.女性2630人(46.4%),平均年龄(55.3±10.7)岁.结果 符合COPD诊断者为473例,总体患病率为8.3%(473/5674),既往从未诊断的有354人,漏诊者占检出COPD患者的74.8%(354/473),主要分布在Ⅰ期和Ⅱ期,这两期共漏诊COPD患者245例,占漏诊患者的69.2%(245/354).COPD总数组和不同性别组(Ⅰ期+Ⅱ期)和(Ⅲ期+Ⅳ期)的漏诊与诊断患者相比,差异均有统计学意义.473例COPD患者中仅119例(诊断率为25.2%)曾经诊断为"气管炎",仅48例(占诊断患者的41.2%)用药,13例(占诊断患者的10.9%)规律使用药物.结论 宁波地区40岁以上居民COPD的总体患病率高,诊断率低,(Ⅰ期+Ⅱ期)漏诊率明显增加,正规治疗者少,其诊断和治疗现状远不能令人满意,应加强COPD的管理,以改善患者预后,减轻家庭、社会负担.

abstractsObjective To determine the prevalence and treatment of chronic obstructive pulmonary diseases (COPD) among citizens in Ningbo. Methods A multi-stage stratified random sampling was applied to select 8 neighborhoods and 3 villages out of 7 districts in Ningbo, people who were older than or equal to 40 years were enrolled as subjects. Information on the prevalence rate and treatment conditions of COPD was collected through respiratory symptoms and treatment questionnaire and lung function screening. Results A total of 5865 people were screened, 5674 of them met inclusion criteria and completed questionnaire and lung function test. Among whom, 3044 people were men (53.6%, the average age is 55.7±11.4), 2630 women (46.4%, the average age was 55.3 ± 10.7);473 of them were diagnosed with COPD, the overall prevalence rate was 8.3%, including 354 cases who had never been diagnosed as COPD, accounted for 74.8% of the total cases diagnosed with COPD, mainly in stage ⅠandⅡof the disease. There were statistically significant differences between diagnosed and undiagnosed patients in the overall COPD group and among different gender groups ( stagesⅠandⅡ) and (stagesⅢandⅣ). Among the 473 COPD cases, 119 (diagnostic yield 25.2%) of whom had been diagnosed with bronchitis, only 48 (41.2%of the diagnosed) received drug treatment, only 13 patients were treated regularly with medication. Conclusion The overall prevalence rate of COPD among those over 40 years of age in Ningbo was quite high and mainly had stagesⅠandⅡof the disease. The number of the diagnostic yield and those who received regular treatment are quite low. The current situation of diagnosis and treatment are far from satisfaction, management of COPD should be strengthened to reduce the burden for family and society.