宁夏慢性阻塞性肺疾病危险因素流行病学调查

Risk factor analysis of chronic obstructive pulmonary disease in Ningxia hui autonomous region

目的分析宁夏地区慢性阻塞性肺疾病（COPD）的相关危险因素，为该疾病的防治提供依据。方法采用多阶段整群随机抽样方法，选取2010年4—11月宁夏省4个地级市抽取12个调查点，对40岁以上的常住人口进行调查。所有受调查者统一接受问卷调查及肺功能检测。采用Logistic回归分析对诊断为COPD患者进行危险因素分析。结果实际调查4626人，有效问卷4055份，有效应答率为87．66％。宁夏COPD的患病率为8．9％。单因素分析示，性别、年龄、城乡、民族、文化程度、吸烟与否、被动吸烟、职业接触、居住地灰尘、儿童时期呼吸道疾病史、肺病家族史、体重指数与COPD相关，差异有统计学意义（P〈0．05）。多因素逐步Logistic回归分析示，性别（OR0．591，95％C10．442～0．791）、年龄（OR1．467，95％CI1．313～1．639）、体重指数（OR0．640，95％C10．517～0．791）、吸烟指数（OR1．431，95％CI1．293—1．585）、职业接触史（OR1．428，95％CI1．114一1．830）、儿童时期呼吸系统疾病史（OR2．137，95％CI1．500～3．045）及肺病家族史（OR4．400，95％CI3．262—5．934）为COPD主要的危险因素。结论宁夏地区COPD患病密切相关的危险因素为男性、高龄、低体重指数、高吸烟指数、职业接触史、儿童时期呼吸系统疾病史及肺病家族史。

Objective To analyze the risk factors of chronic obstructive pulmonary disease in Ningxia district in the hope of providing evidence for COPD prevention. Methods Population-based cluster samples were randomly selected from twelve sites of four prefectures in Ningxia district. All residents over 40 years old were interviewed with a questionnaire and under- went the spirometry. Logistic regression analysis was done to screen related factors of diagosed COPD patients. Results A total of 4055 valid questionnaires were returned from 4626 actual participants with an effective response rate of 87.66%. The overall prevalence of COPD was 8.9%. Univariate analysis showed that gender, age, living areas, ethnicity, educational level, smoking or not, passive smoking, occupational exposure, exposure to residential dust, history of childhood respiratory diseases and family history of respiratory diseases were associated with COPD （ P 〈 0. 05 ）. The main risk factors for COPD were gender （ OR 0. 591,95 % CI 0. 442 - 0. 791 ）, age （ OR 1. 467,95 % CI 1.313 - 1. 639 ）, body mass index （ OR 0. 640, 95% C1 0. 517 -0. 791 ） ,smoking index （ OR I. 431,95% CI 1. 293 - 1. 585 ） ,occupational exposure （ OR 1. 428,95% CI 1.114 - 1. 830）, history of childhood respiratory diseases （ OR 2. 137,95 % CI 1. 500 - 3. 045 ） and family history of respir- atory diseases （ OR 4. 400,95% CI 3. 262 - 5. 934） in the muhivariate analysis （ P 〈 0. 05 ）. Conclusion Gender, age, body mass index, smoking index, occupational exposure, history of childhood respiratory diseases and family history of respir- atory diseases are the most important risk factm＇s in Ningxia Hui Autonomous Region. It is necessary to understand the ge- netic background related to COPD.