我国7省市城区40岁及以上居民支气管扩张症的患病情况及危险因素调查

The prevalence and risk factors of bronchiectasis in residents aged 40 years old and above in seven cities in China

目的 了解我国7省市城区支气管扩张症的患病状况及危险因素.方法 本研究为横断面调查.采用多阶段整群随机抽样方法,在北京市、上海市、广东省、辽宁省、天津市、重庆市和陕西省各抽取一个城市街道作为调查点,对≥40岁的人群进行问卷调查和肺功能检测,询问既往是否被医生诊断过支气管扩张症、是否有呼吸症状及可能的危险因素等.结果 全国7省市城区共抽样≥40岁的居民14 337人,完成有效调查10 811人,调查应答率为75.4％.1.2％ （135/10 811）的≥40岁居民曾诊断患有支气管扩张症,其中男性为1.5％ （65/4382）,女性为1.1％（70/6429）,男女间差异无统计学意义（P =0.070）；支气管扩张症患病随年龄增加而增多；各地区间支气管患病情况差异无统计学意义（P =0.103）,经多因素logistic逐步回归分析校正混杂因素后,各地区间的支气管扩张症的患病情况差异有统计学意义（Wald值为22.116,P=0.001）；多因素logistic逐步回归分析还显示,年龄越大、有呼吸疾病家族史、有儿童时期呼吸道感染史、燃煤暴露、既往患慢性咽炎、肺结核、心脏病和肺癌与支气管扩张症相关；儿童时期感染≥2种呼吸道疾病的人群、家族中≥2人患呼吸疾病的人群患支气管扩张症的相对危险度增加.结论 我国城区≥40岁人群支气管扩张症患病多,其患病与年龄、有呼吸疾病家族史、有儿童时期呼吸道感染史、燃煤暴露、既往患慢性咽炎、肺结核、心脏病和肺癌等因素有关.

Objective To investigate the prevalence and risk factors of bronchiectasis in urban city of China. Methods A cross-sectional survey was conducted in 17 urban areas in Beijing, Shanghai, Tianjin, Chongqing cities, and Guangdong, Liaoning, Shaanxi provinces. In this study, urban population- based cluster samples were randomly selected from each city/province. In the selected city communities, all residents at least 40 years old were recruited, interviewed with questionnaires and tested with spirometry. Each participant was asked whether he/she was ever diagnosed as bronchiectasis by physician, whether had symptoms of respiratory diseases and possible risk factors, etc. Results Data of 10 811 participants was enrolled for analysis, with a response rate of 75.4% （10 811/14 337）. The overall prevalence of physician- diagnosed bronchiectasis was 1.2% （ 135/10 811 ）, with 1.5% （65/4382） in male and 1.1% （70/6429） in female, without statistical difference in gender （X2 -- 3. 289, P = 0. 070 ）. Prevalence of bronchieetasis increased with age （X2 = 31. 029, P 〈 0. 001 ）. There were no statistical signifieanees in crude prevalences of bronchiectasis among cities （Xz = 10. 572, P = 0. 103 ） , while there was a significant difference among cities after adjustment with eonfounders（ Wald value = 22. 116, P = 0. 001 ） , by using logistie regression analysis. Logistie regression analysis showed, broncbiectasis was significantly associated with elder （ t〉 70 years vs 40-49 years; OR =4. 11, 95% CI 2.29-7.36）, the family history of respiratory diseases （having two subjects with respiratory diseases in family vs no suffered relatives; OR = 2. 04, 95% CI 1.06-3.94 ） , respiratory infection during childhood （ suffering two kinds of respiratory diseases vs never; OR = 4.89, 95% CI 2. 03-11.81 ）, exposure to coal （ OR = 2. 30, 95% CI 1.17-4. 52） , chronic pharyngitis（ OR = 3.96, 95 % C1 1.38-11.40） and pulmonary tuberculosis （ OR = 3.07, 95 % C1 1.89-4. 98 ） , heart diseases （ OR = 1.64, 95% CI 1.11-2.42） and lung cancer（OR = 18.61, 95% CI 7.67-45.18）. Conclusion The prevalence of bronehiectasis in population aged 40 years old and above in urban area in China is high and associated with multiple factors such as age, family history of respiratory diseases, respiratory infection during childhood, exposure to coal, chronic pharyngitis, pulmonary tuberculosis, heart diseases, lung cancer and so on.