招远市农村慢性阻塞性肺疾病危险因素分析

Epidemiological Study on the Correlative Risk Factors for Chronic Obstructive Pulmonary Disease in Zhao-Yuan Rural Area

目的了解招远市农村慢性阻塞性肺疾病(COPD)的患病情况及相关危险因素,为COPD的社区防治提供依据。方法从2003年11月—2005年1月,通过机械抽样的方法,抽取招远市35个自然村,对≥40岁的农民6496人问卷调查。凡1秒钟用力呼气量/用力肺活量(FEV1/FVC)<70%者诊断为COPD。结果调查5503人,与危险因素相关的2616人中确诊COPD 807人,患病率14.66%。吸烟人群患病率为27.80%,木工、管理果园、加工石材、生产粉丝及接触化工、谷尘、水泥和下矿井者患病率分别为21.74%,20.86%,28.89%,22.79%,33.33%,30.55%,36.84%,25.93%,均比总体患病率高,经比较,差别均有统计学意义(P<0.05);年龄越大,患病率越高。70岁以上人群COPD的患病率(26.88%)是40～49岁人群的4倍。结论招远市40岁以上的农民COPD患病率为14.66%,除吸烟是COPD主要危险因素外,从事果园管理、石材加工、粉丝生产、采矿、化工作业以及经常接触水泥、谷尘等职业是引发COPD的危险因素。

Objective To investigate the prevalence and the correlative risk factors for Chronic Obstructive Pjlmonary Disease COPD in Zhao-Yuan rural area, Shandong Province. Method From November 2003 to January 2005, 6 496 rural people （≥40 years old） were selected form the whole population in 35 nature villages by simple random method and investigated with questionnaires by the special investigators from door to door.The people who exposed to risk factors such as history of chronic airway inflammation, smoking index ≥ 300, jobs as mineworker, stonemason, vermicelli maker, chemical plant worker, cement plant worker, grist dust contacts, and orchard farmer, were classified into the risk population of COPD.These people were examined by lung function test, and those with FEV1/FVC〈70% were diagnosed as COPD. ResuR Totally 5 503 people finished questionnaries.2 221 subjects out of the 2 616 ones who had history of exposure to risk facotrs were examined by lung function test.The general prevalence of COPD in people aged 40 years or elder in Zhaoyuan rural area was 14.66%.The smoking prevalence was 27.8%.The prevalence of COPD in orchard farmer, stonemason, vermicelli maker, chemical plant worker, grist dust contacts, cement plant worker, mineworker, and carpenter was 20.66%, 28.83%, 22.79%, 33.33%, 30.55%, 36.8%, 25.8%, 21.7%, respectively.These were all higher than the general prevalence in this area and had significant differences. The study showed that the prevalence of COPD increased with the age and the prevalence in the population aged 70 years or over was 4 times higher than that in population aged from 40 to 49 years. Conclusion Smoking and some special employments were higher risk factors for COPD.