国际权威的医学学术期刊American Journal of Respiratory and Critical Care Medicine近日刊登了一篇关于一项关于慢性气流阻塞的患病率和人群归因风险的大型多中心研究文章《Prevalence and Population-Attributable Risk for Chronic Airflow Obstruction in a Large Multinational Study》。

        具体研究如下

        ▶原理：全球疾病负担方案发现吸烟、环境和家庭空气污染是慢性阻塞性肺病导致死亡和残疾的主要原因。

        ▶目的：评估由多种危险因素引起的慢性气流阻塞(CAO)的可归因风险，CAO是慢性阻塞性肺病的一个可量化特征。

        ▶方法：本研究是一项横断面研究，对象为年龄≥40岁的成年人。在全球分布的41个城市和农村地区，基于28459名参与者的数据。

        我们估计了CAO的患病率(定义为支气管扩张剂后fev1 - fvc比低于正常下限)，以及不同危险因素相关的相对风险，利用贝叶斯层次模型从不同方面借用信息来估计局部相对风险。根据这些相对危险度和危险因素的流行程度，估计当地人群归因危险度。

        ▶措施和主要结果：慢性气流阻塞的平均患病率为男性11.2%，女性8.6%，吸烟的平均人群归因风险男性为5.1%，女性为2.2%。

        其次是教育程度低、工作时间≥10年、体重指数低和肺结核史，不同的危险因素导致CAO的风险在不同的位点有所不同。

        ▶结论：虽然吸烟仍然是最重要的危险因素，但在某些地区，教育程度低、体重指数低和被动吸烟更为重要。在一些场所，多尘职业和结核病是重要的危险因素。

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