农村居民慢性阻塞性肺疾病及影响因素分析

目的了解湖南省农村居民慢性阻塞性肺疾病(COPD)患病情况和相关危险因素,为防治慢性阻塞性肺部疾病提供依据。方法以单纯整群抽样方法抽取湖南省攸县3个自然村≥15岁居民4 021人,进行问卷调查、体格检查和肺功能普查,对肺功能1秒用力呼气容积(FEV1)和用力肺活量(FVC)的比值(FEV1/FVC)<70%者进行心电图和X光片检查,对COPD影响因素进行Logistic回归分析。结果有效调查4 003人,有效率为97%;检出COPD患者213例,患病率为5.32%,其中,男性患病率为8.7%,女性为2.2%,男性高于女性(χ2=84.838,P<0.05),随年龄增大患病率逐渐上升(P<0.05),随受教育程度增高患病率逐渐下降;非条件Logistic回归分析结果显示,年龄(OR=1.48)、男性(OR=14.16),吸烟(OR=1.79),被动吸烟(OR=10.73),父系无慢性肺部疾病家族史(OR=0.09),经常下厨(OR=5.73),烹饪或取暖使用煤、柴草燃料(OR=3.44),接触粉尘或有害气体(OR=6.16),受教育程度(OR=0.07);差异均有统计学意义(均P<0.05)。结论湖南省农村COPD患病率较高,影响因素较多,应进行针对性干预。

Epidemic situation and risk factors of COPD among rural residents

Objective To examine the prevalence and relevant risk factors of chronic obstructive pulmonary disease(COPD) among rural residents in Hunan province and to provide basis for the prevention and treatment of COPD.Methods A questionnaire survey was conducted among 4 021 residents aged over 15 years with simple cluster random sampling method in three villages of You county.All respondents filled out a unified epidemiological questionnaire and received a physical examination and lung function test.The respondents with forced expiratory volume in 1s/forced vital capacity(FEV1/FVC)<70% were further examined with X-ray inspection.The data collected were analyzed with multivariate logistic regression method.Results The number of respondents was 4 003 with a response rate of 97%.There were 213 respondents diagnosed with COPD with a total prevalence rate of 5.32%.The prevalence of COPD was 8.7% in the males and 2.2% in the females.The prevalence of COPD in the males was significantly higher than that in the females(χ2=84.838,P<0.05).The prevalence increased with increment of age(P<0.05).The respondents with higher education had a lower prevalence of COPD.The odds ratio(OR) of COPP for age was 1.48(P<0.05)and OR for male was 14.16(P<0.05).The OR of COPD for the smokers was 1.79(P<0.05)and the prevalence of COPD was related to smoking intensity.The passive smoking increased the risk of COPD with an OR of 10.73(P<0.05).The OR for COPD in the residents without paternal family history of chronic pulmonary disease was 0.09(P<0.05).The time of cooking above six month increased the risk of COPD with an OR of 5.73(P<0.05).Using coal and firewood fuels in cooking and warming raised the prevalence of COPD(OR=3.44,P<0.05).The occupational inhalation of dust and exposed to harmful gas increased the risk of COPD with an OR of 6.16(P<0.05).The OR of COPD for education level was 0.07(P<0.05).Conclusion The prevalence of COPD in rural residents of Hunan province is high and there are many relevant risk factors of COPD.