唐山农村地区慢性阻塞性肺疾病患病率调查

Survey on prevalence of chronic obstructive pulmonary disease in rural areas of Tangshan

目的调查唐山农村地区≥40岁人群慢性阻塞性肺疾病(COPD)的患病率及其危险因素。方法采用统一的流行病学调查量表,以整群随机抽样方法,在唐山农村地区共调查≥40岁常住人口2 015例,并进行肺功能检测,对气流受限者行支气管舒张试验。结果资料完整者1 948例,男1 010例,女938例,平均年龄(55.5±11.2)岁;唐山农村地区≥40岁人群COPD患病率为10.7%(209/1 948),男性患病率明显高于女性(13.3%vs 8.0%,P<0.01);随着年龄增长,COPD患病率呈增加趋势(P<0.01);吸烟、室内空气污染、有机燃料、家族史及既往个人史使COPD患病率明显增加(均P<0.01);logistic回归分析显示年龄、吸烟、既往个人史是COPD的独立危险因素(均P<0.01)。结论唐山市农村地区COPD患病率较高;年龄、吸烟、室内空气污染、有机燃料、家族史及既往个人史是COPD的主要危险因素;肺功能检查在COPD的早期诊断中非常重要。

Objective To understand the prevalence and the risk factors of chronic obstructive pulmonary diseases（COPD） in people aged over 40 years old in the rural areas of Tangshan city. Methods Using uniform scheme, procedures and questionnaire,a cluster-randomized-sampling survey for the population aged over 40 years in rural areas of Tangshan city was performed. Bronchial dilatation test was performed for every participant who describes a presence of airway obstruction in the spirometry. Results There were 1 948 cases with complete data from 2 015 people aged 40 years including 1 010 males, 938 females with an average age of （55.5 ＋ 11.2） years old. The prevalence rate of COPD was 10.7%（209/1 948） in rural areas of Tangshan city. The male prevalence rate was 13.3% and the female prevalence rate 8.0%. The men＇s prevalence rate was significantly higher than that of women（ P〈0.01）. COPD prevalence increased with aging （ P 〈 0.01 ）. Logistic regression analysis showed that age increased, air pollution indoor, recurrent childhood cough, smoking, smoking types, passive smoking, organic bio-fuels, personal disease history were main risk factors for COPD. Multivariate analysis showed aged, smoking, personal disease history were independently risk factors of COPD. Conclusion COPD prevalence rate is relatively high in the rural areas of Tangshan city. Age, smoking, passive smoking ,organic bio-fuels, recurrent childhood cough are the main risk factors. Spirometry is important in the diagnosis of COPD,especially in the primary stage.