慢性支气管炎患者慢性阻塞性肺疾病发病影响因素的研究

目的 研究慢性支气管炎患者慢性阻塞性肺疾病（COPD）发病的影响。方法 1992年对≥15岁的67251名农民普查发现1999例未发生COPD的慢性支气管炎患者,收集吸烟、COPD家族史、炉灶情况、粉尘接触、肺功能等基线资料。整群随机分为干预区和对照组,对干预区实施戒烟宣传等干预措施。2000年采用分层随机抽样方法抽取1114例进行复查。结果 应答且资料完整者869例（占1114例的78．0％）。吸烟、基线COPD家族史阳性使第1秒用力呼气量（FEV1）和／或第1秒用力呼气量百分比（FEV1／FVC）随年龄下降速度加快,戒烟者与不吸烟者下降速度无显著差异。COPD8年累积发病与基线年龄、吸烟、COPD家族史阳性呈独立的正相关,而与基线FEV1和FEV1／FVC呈独立的负相关,戒烟与不吸烟者发病危险差异无显著意义。结论 衰老、吸烟、COPD家族史、肺功能低下且慢性支气管炎患者COPD发病独立的危险因素,特别不是独立的危险因素,戒烟可使吸烟者发病危险降低至近似于不吸烟者的水平。

Risk factors of chronic obstructive pulmonary disease in patients with chronic bronchitis

Objective To explore the risk factors of chronic obstructive pulmonary disease (COPD) in patients with chronic bronchitis in following-up 8 years. Methods The baseline survey of the study was carried out on 1 999 patients with chronic bronchitis screened out from 67 251 (15 years or more) rural people in 1992. In 2000, 1 114 patients were reexamined by simple random sampling method. Results 869 (78.0% of 1 114 ) with complete data entered analysis of this study. Smoking, and family history of COPD were associated significantly positively with the decrement per capita yearly of FEV 1 (forced expiratory volume in the first second) and/or FEV 1/FVC (forced vital capacity) ratio. Ex-smoking decreased the decrement of lung function in smokers. The accumulative incidence of COPD was associated positively with smoking and family history of COPD and negatively with baseline FEV 1 and FEV 1/FVC. The relative risk of COPD was not significantly different between non-smokers and ex-smokers. Conclusion For Chinese rural patients with chronic bronchitis, aging, smoking, family history of COPD, lower pulmonary function are independent risk factors of COPD while sex is not one. Ex-smoking can almost decrease the relative risk of COPD to the approximative risk level of non-smoking.