湖北省慢性阻塞性肺疾病流行病学调查及影响因素分析

目的 了解湖北省四个监测点慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）的患病情况及相关影响因素。方法 2014-2015年在湖北省开展2 400人的人群调查，按照多阶段分层整群抽样的方法抽取40岁及以上的居民，对人群进行问卷调查、身体测量和肺功能检查。采用复杂抽样设计的χ2检验和非条件Logistic回归模型对该人群COPD患病相关因素进行分析。结果 共调查40岁以上成年人2 389人，COPD患病人数为213人（占8.92%）。经复杂加权后患病率为12.36%（95%CI:6.95%~17.77%），乡村患病率（13.96%）高于城镇（9.04%），男性患病率（17.47%）高于女性（6.54%）。χ2检验结果显示，地区、性别、年龄、收缩压、体质指数（body mass index，BMI）和是否吸烟是COPD患病的相关因素（均有P<0.05）。多因素Logistic回归分析结果显示，与40~岁年龄组相比，年龄在50~岁（OR=2.316，95%CI:1.999~2.683）、60~岁（OR=4.641，95%CI:2.479~8.687）和70岁及以上（OR=9.066，95%CI:5.735~14.333）会增加COPD患病风险；吸烟（OR=3.376，95%CI:2.357~4.834）和使用家庭取暖污染燃料（OR=1.734，95%CI:1.264~2.380）也是COPD患病的危险因素；与低体重相比，超重（OR=0.599，95%CI:0.367~0.978）和肥胖（OR=0.404，95%CI:0.218~0.752）的人群患COPD的风险较低。结论 湖北省乡村人群中男性的COPD患病率较高，年龄大、有吸烟史、使用家庭取暖污染燃料的人群患COPD的风险较高，应开展有针对性的干预措施。

An epidemiological survey and risk factors analysis of chronic obstructive pulmonary disease in Hubei Province

Objective To investigate the prevalence and related influencing factors of chronic obstructive pulmonary disease in four disease surveillance points of Hubei Province. Methods A total of 2 400 residents aged over 40 years were surveyed through multistage clustering sampling method by questionnaire, body measurement, and pulmonary function test. Based on the complex sampling design, χ2 test and unconditional multivariate logistics regression analysis were conducted to identify the influencing factors of COPD. Results A total of 2 389 subjects aged over 40 years were recruited. The number of COPD patients was 213, accounting for 8.92%. The prevalence of COPD was 12.36% (95% CI:6.95%-17.77%). The prevalence of rural areas (13.96%) was higher than urban areas(9.04%), and the prevalence of men (17.47%) was higher than women(6.54%). The χ2 tests showed that the region, gender, age, SBP, BMI, and smoking were COPD-related factors (all P<0.05). The multivariate Logistic regression showed that compared with the age group of 40-49, the age group of 50-(OR=2.316, 95% CI:1.999-2.683), 60-(OR=4.641, 95% CI:2.479-8.687) and over 70 (OR=9.066, 95% CI:5.735-14.333) increased the risk of COPD. Smoking (OR=3.376, 95% CI:2.357-4.834) and using polluting fuels for household heating (OR=1.734, 95% CI:1.264-2.380) were risk factors for COPD. Compared with low body weight, people with overweight (OR=0.599, 95% CI:0.367-0.978) and obesity (OR=0.404, 95% CI:0.218-0.752) had lower risk of getting COPD. Conclusions Men from rural areas in Hubei had relatively high COPD prevalence. People who had elder age, smoking history, and been using polluting fuels for household heating had higher risk of COPD. Targeted intervening measures should be carried out for COPD prevention.