中国全科医学2026，Vol.29Issue(19)：2735-2743,9.DOI:10.12114/j.issn.1007-9572.2025.0553
不同筛查指标下慢性阻塞性肺疾病前期人群发展为慢性阻塞性肺疾病风险的Meta分析
The Risk of Pre-COPD Populations Progressing to COPD under Different Criteria:a Meta-analysis
摘要
Abstract
Background Chronic obstructive pulmonary disease(COPD)is one of the three leading causes of death worldwide.Early prevention is particularly important for reducing the global healthcare burden.To enhance clinicians'awareness of high-risk populations for COPD and thereby enable early identification of such individuals,the GOLD guidelines have explicitly introduced the pre-COPD.Compared with the general population,individuals in the pre-COPD stage have a higher incidence of COPD;however,few studies have conducted a quantitative analysis of the relative validity of the various indicators.Objective Clarify the progression of patients with pre-COPD to COPD under different screening indicators,quantify their risk of developing COPD,and compare the clinical value of different screening indicators.Methods Cohort studies on the progression of pre-COPD to COPD published from the establishment of databases to November 30,2025,were retrieved from CNKI,Wanfang Data,VIP Chinese Journal Service Platform,PubMed,Embase,and Web of Science.Two researchers independently conducted retrieval,literature eligibility screening,data extraction,and quality assessment.Meta-analysis was then performed using R 4.4.1.For the difference in COPD incidence between high-risk populations defined by different screening criteria and normal populations,Hazard Ratio(HR),Relative Risk(RR),and Odds Ratio(OR)were collected or calculated for aggregation and comparison to assess the risk.Results A total of 23 studies were included,covering 6 grouping criteria:NOCB,PRISm,FEV1/FVC<75%,DLCO,FEV3/FEV6<lower limit of normal(LLN),and variable airflow limitation.Among them,FEV1/FVC<75%had the strongest correlation with COPD incidence(RR=11.98,95%CI=3.91-36.72).The correlation strength of other indicators in descending order was as follows:variable airflow limitation(RR=4.51,95%CI=2.37-8.57),low DLCO(RR=4.05,95%CI=1.49-11.05),PRISm(RR=2.33,95%CI=1.72-3.14),FEV3/FEV6<LLN(RR=2.11,95%CI=1.48-3.03),and NOCB(RR=1.36,95%CI=1.02-1.81).Conclusion Populations with NOCB,PRISm,low DLCO,variable airflow limitation,FEV3/FEV6<LLN,or FEV1/FVC<75%have a higher risk of developing COPD than normal populations,among which the population with FEV1/FVC<75%has the highest risk.关键词
肺疾病,慢性阻塞性/慢阻肺病前期/保留比率的肺功能受损/可变性气流受限/荟萃分析Key words
Pulmonary disease,chronic obstructive/Pre-COPD/Preserved ratio impaired spirometry/Variable airflow limitation/Meta-analysis分类
医药卫生引用本文复制引用
张文博,王骏龙,张玉萍,蒋帅,王华启..不同筛查指标下慢性阻塞性肺疾病前期人群发展为慢性阻塞性肺疾病风险的Meta分析[J].中国全科医学,2026,29(19):2735-2743,9.基金项目
河南省重大科技专项项目(241100310200) （241100310200）
2023年中青年学科带头人资助项目(12271) （12271）
