Objective: To understand the performance of pulmonary function tests in people aged ≥40 years and its changes in China, and provide evidence for the evaluation of the effect of chronic obstructive pulmonary disease (COPD) prevention and control in China. Methods: The subjects of the survey were from COPD surveillance during 2014-2015 and during 2019-2020, which covered 31 provinces (autonomous regions and municipalities) in China. The survey used multi-stage stratified cluster random sampling method, the trained investigators conducted face-to-face interview to know whether subjects had previous pulmonary function testing or not. Complex sampling weighting was used to estimate the rate of pulmonary function testing in people aged ≥40 years, and the pulmonary function testing rates of the two COPD surveillance periods were compared. Results: A total of 148 427 persons were included in the analysis, including 74 591 persons during 2014-2015 and 73 836 persons during 2019-2020. In 2019-2020, the pulmonary function testing rate in Chinese residents aged ≥40 years was 6.7% (95%CI: 5.2%-8.2%), the rate in men (8.1%, 95%CI: 6.7%-9.6%) was higher than that in women (5.4%, 95%CI: 3.7%- 7.0%), and the rate in urban residents (8.3%, 95%CI: 6.1%-10.5%) was higher than that in rural residents (4.4%, 95%CI: 3.8%-5.1%). The rate of pulmonary function testing increased with the increase of education level. During 2019-2020, the residents with history of chronic respiratory diseases had the highest rate of pulmonary function testing (21.2%, 95%CI: 16.8%-25.7%), followed by the residents with respiratory symptoms (15.1%, 95%CI: 11.8%-18.4%) , the pulmonary function testing rate in those who knew the name of chronic respiratory disease was higher than that in those who did not knew the name of respiratory disease, and the pulmonary function testing rate in former smokers was higher than that in current smokers and non-smokers. Those exposed to occupational dust and/or harmful gases had a higher rate of pulmonary function testing compared with those who were not exposed, and those who used polluted fuels indoors had a lower rate of pulmonary function testing than those who did not use polluted fuels indoors (all P<0.05). Compared with 2014-2015, the pulmonary function testing rate in residents aged ≥40 years in China increased by 1.9 percentage points during 2019-2020, and the rate of pulmonary function testing in groups with different characteristics all increased, and the rates of pulmonary function testing increased by 7.4 percentage points and 7.1 percentage points in residents with respiratory symptoms and in those with history of chronic respiratory diseases (all P<0.05). Conclusions: Compared with 2014-2015, the rate of pulmonary function testing increased in China during 2019-2020 and the increase in residents with history of chronic respiratory diseases and respiratory symptoms was relatively obvious, but the overall pulmonary function testing rate was still at a low level. Effective measures should be taken to further increase the rate of pulmonary function testing.
目的： 了解我国≥40岁人群肺功能检查状况及其变化，为评价我国慢性阻塞性肺疾病（COPD）防控效果提供科学依据。 方法： 调查对象来自2014-2015年、2019-2020年中国居民COPD监测，该监测覆盖我国31个省（自治区、直辖市），采用多阶段分层整群随机抽样方法，由经过培训的调查员面对面询问被调查者既往是否进行过肺功能检查。采用复杂抽样加权估计我国≥40岁人群肺功能检查状况及其95%CI，并比较两次监测调查对象的肺功能检查率。 结果： 共148 427人纳入分析，其中2014-2015年74 591人，2019-2020年73 836人。2019-2020年我国≥40岁居民肺功能检查率为6.7%（95%CI：5.2%~8.2%），男性（8.1%，95%CI：6.7%~9.6%）高于女性（5.4%，95%CI：3.7%~7.0%），城镇居民（8.3%，95%CI：6.1%~10.5%）高于乡村（4.4%，95%CI：3.8%~5.1%）；肺功能检查率随文化程度提升呈上升趋势；有慢性呼吸系统疾病史者肺功能检查率最高（21.2%，95%CI：16.8%~25.7%），有呼吸道症状者次之（15.1%，95%CI：11.8%~18.4%），慢性呼吸系统疾病名称知晓者高于不知晓者，曾经吸烟者高于现在吸烟和从不吸烟者，暴露于职业粉尘和/或有害气体者高于非暴露者，家庭使用污染燃料者低于未使用者（均P<0.05）。与2014-2015年相比，2019-2020年我国≥40岁居民肺功能检查率提高了1.9个百分点，不同特征人群的肺功能检查率均有所提高，有呼吸道症状者和有慢性呼吸系统疾病史者肺功能检查率分别提高了7.4个百分点和7.1个百分点（均P<0.05）。 结论： 我国2019-2020年肺功能检查率较2014-2015年有所提升，有慢性呼吸系统疾病史和呼吸道症状者提高幅度较大，但整体肺功能检查率仍处于较低水平。应进一步采取有效措施以提高肺功能检查率。.