无锡市部分社区慢性阻塞性肺疾病患病率和相关危险因素的研究-现代医学

无锡市部分社区慢性阻塞性肺疾病患病率和相关危险因素的研究

单位：1. 无锡市第五人民医院呼吸科, 江苏无锡 214007;
2. 无锡市长泾医院呼吸内科, 江苏无锡 214000;
3. 无锡市第五人民医院双向转诊科, 江苏无锡 214007;
4. 无锡市第五人民医院肺功能室, 江苏无锡 214007

关键词：慢性阻塞性肺疾病患病率危险因素肺功能

分类号：R563;R195.4

出版年·卷·期（页码）：2017·36·第十一期（1578-1582）

摘要：

目的：了解无锡市慢性阻塞性肺疾病（简称慢阻肺）患病现状，分析其相关危险因素。方法：二阶段随机抽样法确定10个调查点，样本总量、各年龄层的设定参照中国慢阻肺患病率调查方法的研究设定，被调查者完成慢阻肺筛查问卷，总分大于9分的对象根据中华医学会呼吸病学分会慢阻肺诊治指南的诊断标准进行确诊，确诊患者参照呼吸困难量表（mMRC）进行呼吸困难程度评估，并调查最近1年内发生急性加重的次数，根据2013 GOLD指南的标准分为A、B、C、D 4组，并结合肺功能FEV₁占预计值的百分比进行分级。结果：共发放慢阻肺筛查问卷2 500份，回收资料完整的共2 491份，其中筛查诊断慢阻肺201例，占调查人数的8.0%，其中A组87例（43.3%），B组25例（12.3%），C组53例（26.4%），D组36例（18.0%）。70岁及以上组与70岁以下各组的慢阻肺患病率比较差异有统计学意义；多因素Logistic回归分析结果显示，高年龄、吸烟指数大于200支·年^-1、家族呼吸疾病史和生物燃料暴露史是发生慢阻肺的独立危险因素。结论：高年龄、吸烟、家族呼吸疾病史和生物燃料暴露史是慢阻肺的致病高危因素，早诊早干预，以降低其危害性。

Objective:To investigate the prevalence of chronic obstructive pulmonary disease(COPD) in Wuxi city and to explore the related risk factors. Methods:Two stage sampling method was used to determine ten survey spots at random and the amount of total samples. Age groups were set up with reference to the methodology of China Chronic Obstructive Pulmonary Disease Prevalence Rate Survey Research. The subjects were interviewed with COPD screening questionnaires, whose score was more than 9 could be diagnosed COPD according guideline approved by Chinese Medical Association/respiratory disease branch. According to dyspnea scale (mMRC), the patients were divided into group A, B, C, Dwith dyspnea severity evaluated, as well as the investigation into the occurrence of acute exacerbation in the past years according to the 2013 Gold Guidelines, combined with pulmonary function of predicted percentage of FEV1. Results:2 500 questionnaires were sent to the subjects, a total of 2 491 full questionnaires were collected. 201 cases of COPD patients were diagnosed according to screening questionnaires, accounting for 8.0% of all subjects. Group A, B, C,D accounted for 43.3%(87 cases), 12.3%(25 cases), 26.4%(53 cases), 18.0%(36 cases) respectively. The prevalence rate of COPD was significantly higher among those over 70 years than those under 70 ages (P<0.05). Multiple Logistic regression analysis showed that the independent risk factors of COPD included age, >200 cigarettes·year^-1, family history of respiratory diseases and biomass fuel exposure. Conclusion:The high-risk factors of COPD have been explored by epidemic investigations. Early diagnosis and intervention reduces its damage.

参考文献：

[1] 宫建,杨传家,陈德才,等.沈阳地区慢性阻塞性肺疾病住院患者的初步分析[J].东南大学学报(医学版),2017,36(3):365-368.
[2] Global strategy for the diagnosis,management and prevention of chronic obstructive pulmonary disease[EB/OL].[2017-01-05] .http://www.goldcopd.org.
[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].中华结核和呼吸杂志,2013,36(4):255-264.
[4] 周玉民,刘升明,吕嘉春,等.中国慢性阻塞性肺疾病患病率调查方法的研究设计[J].中华流行病学杂志,2006,27(9):814-818.
[5] 冉丕鑫.应重视慢阻肺社区筛查适宜技术的研究与推广[J].中华结核和呼吸杂志,2015,38(2):87-88.
[6] 钟南山.必须重视COPD早期干预[J].医学研究杂志,2012,41(12):1.
[7] 唐文芳,刘日辉,于雅琴,等.2000-2014年我国40岁以上成人慢性阻塞性肺疾病患病率的Meta分析[J].吉林大学学报(医学版),2015,41(5):961-968.
[8] 白澎,孙永昌,盛海燕,等.北京市社区高危人群慢性阻塞性肺疾病诊断与疾病分类状况调查[J].中国呼吸与危重监护杂志,2014,13(4):330-333.
[9] AGUSTI A,EDWARDS L,CELLI B,et al.Characteristics stability and outcomes of the GOLD 2011 COPD groups in the ECLIPES cohort[J].Eur Respir,2013,42(3):636-646.
[10] ZHANG Y,CAO J,CHEN Y,et al.Intraperitoneal injection of cigarette smoke extract induced emphysema,add injury of cardiac and skeletal muscles in BALB/C mice[J].Exp Lung Res,2013,39(1):18-31.
[11] LEBERL M,KRATZER A,TARASEVICIENE-STEWART L.Tobacco smoke induced COPD/emphysema in the animal model-are we all on the same page[J].Front Physiol,2013,15(4):91-95.
[12] HOFFMANN R F,ZARRINTAN S,BRANDENBURG S M,et al.Prolonged cigarette smoke exposure alters mitochondrial structure and function in airway epithelial cells[J].Respir Res,2013,14(1):97-106.
[13] BANERJEE A,MONDAL N K,DAS D,et al.Neutrophilic inflammatory response and oxidative stress in premenopausal women chronically exposed to indoor air pollution from biomass burning[J].Inflammation,2012,35(2):671-683.
[14] MUKHERJEE S,ROYCHOUDHURY S,SIDDIQUE S,et al.Respiratory symptoms,lung function decrement and chronic obstructive pulmonary disease in premenopausal lndian women exposed to biomass smoke[J].Inhal Toxicol,2014,26(14):866-872.
[15] RAJ T J B.Altered lung function test in asymptomatic women using biomass fuel for cooking[J].J Clin Diagn Res,2014,8(10):BC01-03.
[16] MUKHERJEE N B H,AFANE Z E,CHEBU C,et al.Effects of cooking fuel smoke on respiratory symptoms and lung function in semirural women in Cameroon[J].Int J Occup Environ Health,2015,21(1):61-65.
[17] 赵东兴,陈淑云,周玉民,等.生物燃料烟雾暴露人群肺功能受损情况初步分析[J].中华结核和呼吸杂志,2017,40(5):349-353.
[18] ZHOU Y,ZOU Y,LI X,et al.Lung function and incidence of chronic obstructive pulmonary disease after improved cooking fuels and kitchen ventilation:a 9-year prospective cobort study[J].PLoS Med,2014,11(3):e1001621.

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