湖北省慢性阻塞性肺疾病流行病学调查及影响因素
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摘要
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2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%)。2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。
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,2 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 2 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.
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,2 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 2 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.
引文
[1]Chen Z,Wang JN,Ma GX,et al.China tackles the health effects of air pollution[J].Lancet,2013,382(9909):1959-1960.
[2]Li Q,Hsia J,Yang G.Prevalence of smoking in China in 2010[J].New Engl J Med,2011,364(25):2469.
[3]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中国医学前沿杂志,2014,6(2):67-80.
[4]Yang G,Wang Y,Zeng Y,et al.Rapid health transition in China,1990-2010:findings from the Global Burden of Disease Study2010[J].Lancet,2013,381(9882):1987-2015.
[5]Zhong N,Chen W,Yao W,et al.Prevalence of chronic obstructive pulmonary disease in China:a large,population-based survey[J].Am J Resp Crit Care,2007,176(8):753.
[6]国家卫生计生委疾病预防控制局.中国居民营养与慢性病状况报告(2015年)[M].北京:人民卫生出版社,2015:54.
[7]Regional COPD working group.COPD prevalence in 12 Asia-Pacific countries and region:projections based on the COPD prevalence estimation model[J].Respirology,2003,8(2):192-198.
[8]Celli BR,Macnee W,Agusti A,et al.Standards for the diagnosis and treatment of patients with COPD:a summary of the ATS/ERS position paper[J].Eur Respir J,2004,23(6):932.
[9]国务院办公厅.国务院办公厅关于印发中国防治慢性病中长期规划(2017-2025年)的通知[EB/OL].(2017-02-14)[2017-12-19].http://www.gov.cn/zhengce/content/2017-02/14/content_5167886.htm.
[10]Postma DS,Bush A,Van d BM.Risk factors and early origins of chronic obstructive pulmonary disease[J].Lancet,2015,385(9971):899-909.
[11]吕晓东,陈文宇,刘加良,等.浙江省嘉兴市慢性阻塞性肺疾病的流行病学调查及危险因素分析[J].中国循证医学杂志,2015,15(6):628-632.
[12]肖甜,陈晓英,王娜,等.中国城市社区COPD患者急性加重的相关因素调查[J].中华疾病控制杂志,2017,21(2):110-113.
[13]周亮,曹磊,刘建平,等.溧阳市农村居民慢性阻塞性肺疾病患病率及危险因素研究[J].江苏预防医学,2016,27(6):730-731.
[14]湖北省疾病预防控制中心.湖北省慢性病及其危险因素监测报告2013[M].湖北:湖北科学技术出版社,2017:94-95.
[15]中国疾病预防控制中心.中国慢性病及其危险因素监测报告2013[M].北京:军事医学出版社,2016:36-41.
[16]聂晓红,熊曙光,王慧,等.三种不同体重指数慢性阻塞性肺疾病患者炎性因子的研究[J].中国呼吸与危重监护杂志,2014,13(1):14-17.
[17]潘东霞,钱一建,王春梅,等.吸烟与室内空气污染的交互作用对慢性阻塞性肺部疾病影响的分析[J].中华流行病学杂志,2016,37(11):1444-1449.
[18]韩瑞,邹继华,沈霞,等.黑龙江省慢性阻塞性肺疾病危险因素调查分析[J].中华结核和呼吸杂志,2015,38(2):93-98.
[19]Fullerton DG,Suseno A,Semple S,et al.Wood smoke exposure,poverty and impaired lung function in Malawian adults[J].Int Tuberc Lung D,2011,15(3):391.
[20]姚瑶,申双和.南京市气象条件对慢性阻塞性肺病发病影响的初步研究[J].中华疾病控制杂志,2013,17(6):507-510.
[2]Li Q,Hsia J,Yang G.Prevalence of smoking in China in 2010[J].New Engl J Med,2011,364(25):2469.
[3]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中国医学前沿杂志,2014,6(2):67-80.
[4]Yang G,Wang Y,Zeng Y,et al.Rapid health transition in China,1990-2010:findings from the Global Burden of Disease Study2010[J].Lancet,2013,381(9882):1987-2015.
[5]Zhong N,Chen W,Yao W,et al.Prevalence of chronic obstructive pulmonary disease in China:a large,population-based survey[J].Am J Resp Crit Care,2007,176(8):753.
[6]国家卫生计生委疾病预防控制局.中国居民营养与慢性病状况报告(2015年)[M].北京:人民卫生出版社,2015:54.
[7]Regional COPD working group.COPD prevalence in 12 Asia-Pacific countries and region:projections based on the COPD prevalence estimation model[J].Respirology,2003,8(2):192-198.
[8]Celli BR,Macnee W,Agusti A,et al.Standards for the diagnosis and treatment of patients with COPD:a summary of the ATS/ERS position paper[J].Eur Respir J,2004,23(6):932.
[9]国务院办公厅.国务院办公厅关于印发中国防治慢性病中长期规划(2017-2025年)的通知[EB/OL].(2017-02-14)[2017-12-19].http://www.gov.cn/zhengce/content/2017-02/14/content_5167886.htm.
[10]Postma DS,Bush A,Van d BM.Risk factors and early origins of chronic obstructive pulmonary disease[J].Lancet,2015,385(9971):899-909.
[11]吕晓东,陈文宇,刘加良,等.浙江省嘉兴市慢性阻塞性肺疾病的流行病学调查及危险因素分析[J].中国循证医学杂志,2015,15(6):628-632.
[12]肖甜,陈晓英,王娜,等.中国城市社区COPD患者急性加重的相关因素调查[J].中华疾病控制杂志,2017,21(2):110-113.
[13]周亮,曹磊,刘建平,等.溧阳市农村居民慢性阻塞性肺疾病患病率及危险因素研究[J].江苏预防医学,2016,27(6):730-731.
[14]湖北省疾病预防控制中心.湖北省慢性病及其危险因素监测报告2013[M].湖北:湖北科学技术出版社,2017:94-95.
[15]中国疾病预防控制中心.中国慢性病及其危险因素监测报告2013[M].北京:军事医学出版社,2016:36-41.
[16]聂晓红,熊曙光,王慧,等.三种不同体重指数慢性阻塞性肺疾病患者炎性因子的研究[J].中国呼吸与危重监护杂志,2014,13(1):14-17.
[17]潘东霞,钱一建,王春梅,等.吸烟与室内空气污染的交互作用对慢性阻塞性肺部疾病影响的分析[J].中华流行病学杂志,2016,37(11):1444-1449.
[18]韩瑞,邹继华,沈霞,等.黑龙江省慢性阻塞性肺疾病危险因素调查分析[J].中华结核和呼吸杂志,2015,38(2):93-98.
[19]Fullerton DG,Suseno A,Semple S,et al.Wood smoke exposure,poverty and impaired lung function in Malawian adults[J].Int Tuberc Lung D,2011,15(3):391.
[20]姚瑶,申双和.南京市气象条件对慢性阻塞性肺病发病影响的初步研究[J].中华疾病控制杂志,2013,17(6):507-510.