我国部分农村地区40岁以上女性慢性阻塞性肺疾病危险因素分析

The risk factors for chronic obstructive pulmonary disease in females in Chinese rural areas

目的探究我国农村女性慢性阻塞性肺疾病（COPD）的患病危险因素。方法在全国COPD流行病调查的基础上，选取农村地区40岁以上的女性为分析对象。全国COPD流行病调查采用多阶段分层整群随机抽样方法，进行问卷和肺功能检测；以吸入支气管扩张剂后第1秒钟用力呼气容积（FEV1）／用力肺活量（FVC）〈0．70作为诊断COPD的标准，并排除其他不完全可逆气流受限疾病。结果农村女性总体患病率为5．4％，危险因素暴露率、COPD患病率存在地区差异（P值均小于0.05）；多因素分析显示，COPD的主要危险因素有：家族呼吸疾病史（OR=2．46，95％CI=1．86-3．26）、儿童时期经常咳嗽（经常咳嗽与从无咳嗽比较，OR=3．93，95％CI=2．02-7．63）、年龄大（70岁以上与40-49岁比较，OR=8．98，95％CI=5．90～13．67）、低体重指数（BMI）（低BMI与正常BMI比较，OR=2．20，95％CI=1．47-3．29）、吸烟（OR=1．68，95％CI=1．20-2．35）、有职业粉尘暴露（主要为谷尘暴露，OR=1．45，95％CI=1．07-1．96）、厨房无通风设备（OR=1．47，95％CI=1．06-2．03）和文化程度低（OR=2．19，95％CI=1．38-3．46）。结论中国农村女性COPD的危险因素是多方面的，应重视其防治。

Objective To explore the risk factors for chronic obstructive pulmonary disease （COPD） in females in Chinese rural areas. Methods Based on a national multi-center, population-based and cross-sectional survey on prevalence of COPD in seven provinces/cities of China, an analysis on the risk factors for the rural females was conducted in six areas, e.g. Beijing, Shanghai, Guangdong, Liaoning, Tianjin and Shanxi. In the national survey, for each area, one rural and one urban cluster samples were randomly selected using a multi-stage strategy. Residents who were 40 years old or older were interviewed with questionnaires and tested with spirometry. The post-bronchodialators forced expired volume in one second to forced vital capacity ratio（FEV1/FVC）× 100% 〈70% was used as diagnostic criteria of COPD. Results The average prevalence of COPD in females in the six Chinese rural areas was 5.4%. The prevalence varied with risk factor exposure among different areas, and the prevalence in Guangdong province was the highest among all areas. Logistic regression model was conducted, and statistical association of COPD was found with a family history of respiratory diseases （OR = 2. 46, 95% CI = 1.86 -3.26） , frequent coughing during childhood （ frequent coughing vs never coughing ： OR = 3.93, 95 % CI = 2. 02 - 7.63 ） , lower body mass index（ lower body mass index vs normal body mass index ： OR = 2. 20, 95% CI = 1.47 - 3.29） , age（70 years or older vs 40 - 49 years： OR = 8.98, 95% CI = 5.90 - 13.67 ）, smoking（ OR = 1.68, 95% CI = 1.20 - 2.35 ）, exposure to occupational dusts （ OR = 1.45, 95% CI = 1.07 - 1.96 ）, worse ventilation in kitchen room（ OR = 1.47, 95% CI = 1.06 - 2. 03 ） and lower educational level （ OR = 2. 19, 95% CI = 1.38 -3.46）. Conclusion The prevalence of COPD in females in rural areas was associated with multiple factors and prevention of COPD for Chinese women in rural areas is warranted.