天津市农村地区慢性阻塞性肺疾病流行病学调查

An epidemiological study on chronic obstructive pulmonary disease in a rural area of Tianjin

目的了解天津市农村地区40岁以上人群慢性阻塞性肺疾病的流行病学特点。方法将天津市宝坻区新开口乡5个自然村40岁以上1508名村民作为调查对象,进行流行病学问卷、肺功能测定、体格检查。对确诊慢性阻塞性肺疾病者进行胸部 X 线及心电图检查。结果该地区慢性阻塞性肺疾病患病率为9.4%,其中肺源性心脏病患病率为16.9%。随着年龄的增长,慢性阻塞性肺疾病患病率男性高于女性(13.5%与6.2%),吸烟者高于非吸烟者(12.2%与7.2%),有家族史者高于无家族史者(21.4%与8.5%),幼年前有咳嗽史者高于无咳嗽史者(75.0%与9.2%),P 值均<0.01。单因素回归分析显示,室外空气污染、下厨、使用柴草烹饪时间、吸烟、幼儿时咳嗽史、男性、年龄增长、家族史为慢性阻塞性肺疾病的易患因素。多因素分析显示,男性、年龄增长、家族史为慢性阻塞性肺疾病的独立易患因素。非慢性阻塞性肺疾病者生存质量优于慢性阻塞性肺疾病者,差异具有统计学意义。结论天津市农村地区慢性阻塞性肺疾病患病率较高,主要危险因素为男性、年龄、家族史、吸烟及室外空气污染。

Objective To understand epidemiological characteristics of chronic obstructive pulmonary disease （COPD） in people aged over 40 years in a rural area of Tianjin. Methods Using cluster sampling, 1 508 subjects over 40 years old at five villages in Xinkaikou Township, Baodi District, Tianjin were investigated with respiratory questionnaire, lung function test and physical examination. Confirmed patients with COPD were examined by chest roentgenography and electrocardiography. Results One hundred and forty-two subjects in that area suffered from COPD, with prevalence of 9.4%, 24 of them （16.9%） were diagnosed as cor pulmonale. Prevalence of COPD increased with age, higher in men （13.5%） than that in women （6.2%）, higher in smokers （12.2%） than that in non-smokers （7.2%）, higher in those with family history （21.4%） than that in those without it （8.45%）, and higher in those with coughing history during their childhood （75.0%） than that in those without it （9.2%）, all with a P-value of less than 0.01. Univariate analysis showed that out-door air pollution, cooking, time length of burning firewood during cooking, smoking, coughing history during childhood, gender, age, family history all were predisposing factors for COPD. Multivariate analysis with logistic regression model showed that gender, age, family history were independently predisposing factors for COPD. Quality of life was better in non-COPD subjects than in those with COPD, with statistically significant difference. Conclusions Prevalence of COPD was relatively higher in people of rural Tianjin, with gender, age, family history and outdoor air pollution as main risk factors.