Underdiagnosis of chronic obstructive pulmonary disease in China: epidemiologic study

目的 了解我国慢性阻塞性肺疾病(COPD)诊断情况,为提高COPD防治水平提供依据.方法 以COPD、流行病学调查为主题词,在万方数据库和Medline中检索我国2000年1月-2011年12月公开发表于核心期刊或统计源期刊,样本量≥1000人,有严格质量控制,属于COPD流行病学调查的论著.对国内已发表的COPD流行病学调查结果进行全面检索和系统分析.结果 流行病学调查前患者知道自己患有COPD(其中包括大量的慢性支气管炎、肺气肿)者只有32.90％(1095/3328),流行病学调查前曾经做过肺功能检查的仅有9.13％ (237/2597).已确诊的COPD患者中有咳嗽、咳痰和(或)活动气短症状的比率为65.40％ (2306/3526),流行病学调查中确诊的COPD患者中Ⅰ、Ⅱ级的比率高达74.52％ (1802/2418).结论 目前我国COPD诊断严重不足,Ⅰ、Ⅱ级患者没有得到及早诊断.Objective To investigate underdiagnosis problem of chronic obstructive pulmonary disease (COPD) in China.Methods Articles published during January 1 st,2000 and December 30th,2011were searched in Wanfang Database and Medline,search words including COPD and epidemiology survey.The papers were then reviewed,and those original contirbutions with sample size ≥ 1000 and strict quality control entered into the final analysis.Results Only 32.90％ (1095/3328) COPD patients had ever been diagnosed to have emphysema,bronchitis or COPD,and only 9.13％ (237/2597) had undergone lung function test.About 65.40％ (2306/3526) COPD patients were presented with at least one of the following symptoms:cough,phlegm and breathlessness.Stage Ⅰ or Ⅱ COPD was found in 74.52％ (1802/2418)patients.Conclusion Underdiagnosis of COPD was quite common in China,and patients with stage Ⅰ or Ⅱ COPD should have deserved early diagosis.0144-47