重视慢性阻塞性肺疾病的预防与早期诊断
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摘要
慢性阻塞性肺疾病(简称慢阻肺)是一种常见的严重威胁人类健康的疾病。慢阻肺在我国患病率和病死率均居第3位,且患病率进展迅速,形势严峻,考虑与吸烟人群增加、空气污染严重以及人口老龄化等有关。在中国尤其基层医疗机构,慢阻肺诊治的巨大障碍是临床肺功能检查应用严重不足,主要原因包括对于肺功能检查重要性认识不足、设备缺乏、经费受限等。目前慢阻肺预防工作的重点是戒烟、控制空气污染以及推广肺功能检查。
Chronic obstructive pulmonary disease( COPD) is a common lethal disease. In China,it has the third incidence rate and is also the third leading cause of death. Over the past decades,there is a rapid growth in the prevalence of COPD. The three significant causes are the growth of smoking population,severe air pollution,and the aggravating trend of the aging population. Insufficient clinical application of spirometry is a huge obstacle in the diagnosis and treatment of COPD in China. The reasons for the limited use of spirometry in clinical practice,especially in most primary medical institutions,include poor understanding of the significance of pulmonary function tests,lack of equipment,and financial constraints. Main methods for the prevention of COPD include smoking cessation,control of air pollution,and the promotion of pulmonary function testing.
Chronic obstructive pulmonary disease( COPD) is a common lethal disease. In China,it has the third incidence rate and is also the third leading cause of death. Over the past decades,there is a rapid growth in the prevalence of COPD. The three significant causes are the growth of smoking population,severe air pollution,and the aggravating trend of the aging population. Insufficient clinical application of spirometry is a huge obstacle in the diagnosis and treatment of COPD in China. The reasons for the limited use of spirometry in clinical practice,especially in most primary medical institutions,include poor understanding of the significance of pulmonary function tests,lack of equipment,and financial constraints. Main methods for the prevention of COPD include smoking cessation,control of air pollution,and the promotion of pulmonary function testing.
引文
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[10] He MZ,Zeng X,Zhang K,et al. Fine Particulate Matter Concentrations in Urban Chinese Cities,2005-2016:A Systematic Review[J]. Int J Environ Res Pub Heal,2017,14:191-204.
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[12] Hnizdo E,Sullivan PA,Bang KM,et al. Association between chronic obstructive pulmonary disease and employment by industry and occupation in the US population:a study of data from the Third National Health and Nutrition Examination Survey[J]. Am J Epidemiol,2002,156:738-746.
[13] Balmes J,Becklake M,Blanc P,et al. American Thoracic Society Statement:Occupational contribution to the burden of airway disease[J]. Am J Respir Crit Care Med,2003,167:787-797.
[14] Martinez FJ,Han MK,Allinson JP,et al. At the Root:Defining and Halting Progression of Early Chronic Obstructive Pulmonary Disease.[J]. Am J Respir Crit Care,2018,196:1540-1551.
[2] Zhou M,Wang H,Zhu J,et al. Cause-specific mortality for240 causes in China during 1990-2013:a systematic subnational analysis for the Global Burden of Disease Study 2013[J]. Lancet,2016,387:251-272.
[3]程显声,李景周.慢性阻塞性肺疾病、肺心病人群防治的研究基线资料分析[J].中华结核和呼吸杂志,1998,21:749-752.
[4] Xu F,Yin X,Zhang M,et al. Prevalence of physician-diagnosed COPD and its association with smoking among urban andrural residents in regional mainland China[J]. Chest,2005,128:2818-2823.
[5] Zhong N,Wang C,Yao W,et al. Prevalence of chronic obstructive pulmonary disease in China:a large,populationbased survey[J]. Am J Respir Crit Care, 2007, 176:753-760.
[6] Wang C,Xu J,Yang L,et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China(the China Pulmonary Health[CPH] study):a national crosssectional study[J]. Lancet,2018,391:1706-1717.
[7] Brunekreef B,Holgate ST. Air pollution and health[J].Lancet,2002,360:1233-1242.
[8] Schikowski T,Adam M,Marcon A,et al. Association of ambient air pollution with the prevalence and incidence of COPD[J]. Eur Respir J,2014,44:614-626.
[9] Liu S,Zhou Y,Liu S,et al. Association between exposure to ambient particulate matter and chronic obstructive pulmonary disease:results from a cross-sectional study in China[J].Thorax,2017,72:788-795.
[10] He MZ,Zeng X,Zhang K,et al. Fine Particulate Matter Concentrations in Urban Chinese Cities,2005-2016:A Systematic Review[J]. Int J Environ Res Pub Heal,2017,14:191-204.
[11] Guan WJ,Zheng XY,Chung KF,et al. Impact of air pollution on the burden of chronic respiratory diseases in China:time for urgent action[J]. Lancet,2016,388:1939-1951.
[12] Hnizdo E,Sullivan PA,Bang KM,et al. Association between chronic obstructive pulmonary disease and employment by industry and occupation in the US population:a study of data from the Third National Health and Nutrition Examination Survey[J]. Am J Epidemiol,2002,156:738-746.
[13] Balmes J,Becklake M,Blanc P,et al. American Thoracic Society Statement:Occupational contribution to the burden of airway disease[J]. Am J Respir Crit Care Med,2003,167:787-797.
[14] Martinez FJ,Han MK,Allinson JP,et al. At the Root:Defining and Halting Progression of Early Chronic Obstructive Pulmonary Disease.[J]. Am J Respir Crit Care,2018,196:1540-1551.