山东省40岁及以上居民慢性阻塞性肺疾病患病情况及危险因素分析

目的 了解山东省≥40岁居民慢性阻塞性肺疾病患病率及危险因素，为制定防控策略提供依据。方法 2015年7月—2016年2月，采用分层整群随机抽样的方法在山东省抽取3 600名≥40岁居民进行问卷调查、体格检查及肺功能检查。采用复杂抽样加权估算慢阻肺的患病率，并应用多因素logistic回归模型分析患病的危险因素。结果 本次调查项目全部完成且质控合格的共3 317人，慢阻肺患病471人，经复杂加权后山东省≥40岁居民慢阻肺患病率为13.391%，男性患病率为20.200%，女性为6.632%，男性高于女性（χ2 = 95.359,P＜0.001），40～49岁、50～59岁、60～69岁、≥70岁年龄组的患病率分别为6.549%、10.837%、19.991%、23.632%，随年龄的增长患病率增高（χ2 = -12.018,P＜0.001）；多因素logistic回归分析显示,性别（OR = 2.416,95%CI = 1.639～3.561）、年龄（OR = 3.749，95%CI = 1.883～7.467）、有慢性支气管炎（简称慢支）等慢性呼吸系统疾病家族史（OR = 1.444，95%CI = 1.127～1.849）、儿童时期严重肺部感染史（OR = 3.183，95%CI = 1.414～7.168）、吸烟（OR = 2.207，95%CI = 1.805～2.698）、做饭时不通风（OR = 1.361，95%CI = 1.021～1.814）等是慢阻肺患病的危险因素。结论 山东省≥40岁居民慢阻肺患病率较高，应从各项危险因素入手，特别是男性、高龄、有慢性呼吸系统疾病家族史、吸烟、儿童时期严重肺部感染史、室内空气污染等方面，加强对慢阻肺的防控。

Prevalence and risk factors of chronic obstructive pulmonary disease among residents aged 40 years and above in Shandong Province

Objective To investigate the prevalence and risk factors of chronic obstructive pulmonary disease (COPD) among residents aged 40 years and above in Shandong Province and to provide reference for disease prevention and control. Methods From July 2015 to February 2016, a stratified whole-group random sampling method was used to select 3 600 residents aged ≥40 years in Shandong Province for questionnaire survey, physical examination, and pulmonary function test. The prevalence of COPD was estimated using complex sampling weighting, and multi-factor logistic regression models were applied to analyze the risk factors for the disease. Results A total of 3 317 people completed the survey and passed the quality control, and 471 people were affected by COPD. The prevalence of COPD among residents aged ≥40 years in Shandong Province was 13.391% after complex weighting, with a prevalence of 20.2% among men and 6.632% among women, with a higher prevalence among men than women (χ2=95.359, P<0.001). The prevalence rates were 6.549%, 10.837%, 19.991%, and 23.632% in the age groups of 40-49, 50-59, 60-69, and ≥70, respectively, and increased with age (χ2=-12.018, P<0.001). The multifactorial logistic regression analysis showed that gender(OR=2.416, 95%CI: 1.639-3.561), age (OR=3.749, 95%CI: 1.883-7.467), family history of chronic bronchitis and other chronic respiratory diseases (OR=1.444, 95%CI: 1.127-1.849), history of severe pulmonary infections in childhood (OR=3.183, 95%CI: 1.414-7.168), smoking (OR=2.207, 95%CI: 1.805-2.698), and lack of ventilation while cooking (OR=1.361, 95%CI: 1.021-1.814) were risk factors for the prevalence of COPD. Conclusion The prevalence of COPD is high among residents aged ≥40 years in Shandong Province, and the prevention and control of COPD should be strengthened considering various risk factors, especially men, advanced age, family history of chronic respiratory diseases, smoking, history of severe lung infections in childhood, and indoor air pollution.