社区35岁以上人群慢性阻塞性肺疾病流行病学患病率及危险因素研究

目的了解沈阳部分社区35岁以上人群慢性阻塞性肺疾病(COPD)的患病率及危险因素,为COPD社区防治提供基础数据。方法采用统一的流行病学调查表,以整群随机抽样的方法,对沈阳市中山社区和桂林社区35～80岁居民进行问卷调查,并进行体格检查和肺功能检测,取资料完整的2 194份问卷进行分析。结果调查资料完整且肺功能检查合格的2 194例人群中,男903例,女1 291例,平均年龄为55.8岁。COPD患病率为5.1%,其中男性患病率为6.5%,女性患病率为4.1%,男性患病率高于女性,差异有统计学意义(P<0.05)。被调查人群的吸烟率为37.1%,男性吸烟率明显高于女性,差异有统计学意义(P<0.05)。吸烟者中COPD的患病率为10.33%,显著高于非吸烟人群,差异有统计学意义(P<0.05),而COPD人群中吸烟率为75.0%。单因素分析结果显示:吸烟、年龄、低体质指数、6个月以上的燃煤应用史是COPD的可能危险因素,而良好的家庭收入和文化水平是COPD的保护因素。多元回归分析显示,吸烟和年龄是COPD的危险因素。结论沈阳市部分社区35岁以上人群COPD患病率为5.1%,吸烟和年龄是COPD患病的主要危险因素。除了吸烟和年龄以外,低体质指数、6个月以上的燃煤应用史、经济状况和受教育程度也是COPD的可能危险因素。控烟、改善经济状况和提高文化素质将有利于COPD的社区防治。

Prevalence Rate and Risk Factors of Chronic Obstructive Pulmonary Disease in Residents Aged 35 Years or Older in Communities of Shenyang City

Objective To investigate the prevalence rate and risk factors of chronic obstructive pulmonary diseases(COPD) among residents who were 35 years or above in parts of communities of Shenyang city,in order to provide the basis data to the community prevention and treatment of COPD.Methods Cluster-random-sampling was taken in performance of the epidemiological questionnaire survey among people aged ranging from 35 to 80 years old from Guilin community and Zhongshan community of Shenyang city.All the subjects underwent spirometry and physical examination,and the complete data obtained from 2 194 eligible questionnaires were analyzed.Results Among the 2 194 cases with full data and qualified spirometry test,there were 903 males and 1 291 females,with an average age of 55.8 years old.The prevalence rate of COPD was 5.1%.The male prevalence rate was 6.5% and the female prevalence rate was 4.1%,with a significant difference(P<0.05).The total smoking rate of the subjects was 37.1%.The smoking rate of males was higher than that of females(P<0.05).Among the smoking population,the prevalence rate of COPD was 10.33%,which was higher than that of the non-smokers(P<0.05).Among the COPD patients,the smoking rate was 75.0%.Univarible analysis showed that smoking,age,lower body mass index(BMI),and the history of coal fire above 6 months were the possible risk factors of COPD;while good family income and education level were the protective factors of COPD.Logistic progression analysis showed that smoking and age were the major risk factors of COPD.Conclusion The prevalence rate of COPD in the population aged above 35 years old from the two communities in Shenyang city was 5.1%.Smoking and age are the major risk factors of COPD.Besides,lower BMI,history of coal fire above 6 months,family income and education level are potential risk factors of COPD.So to control,smoking,improve economic condition and increase education level are helpful for prevention and control of COPD in community.