不吸烟和吸烟的慢性支气管炎人群慢性阻塞性肺疾病患病率和临床特征的研究

Prevalence and Clinic Characteristics of Chronic Obstructive Pulmonary Disease (COPD) in Smoking or Non-smoking Patients with Chronic Bronchitis

目的观察不吸烟和吸烟的慢性支气管炎人群中慢性阻塞性肺疾病 (COPD)的患病率和临床特征。方法1992年筛选出 2 395例慢性支气管炎患者 ,不吸烟组 95 2例 ,吸烟组 144 3例 ,经问卷、查体、肺功能测量调查COPD患病情况。结果 1不吸烟组 COPD患病率低于吸烟组 (37.7%和 43.1%,P=0 .0 0 9) ,两组均随年龄和咳嗽年限升高 ,吸烟组患病率随年龄升高幅度大于不吸烟组。 2控制性别等因素后 ,吸烟组肺功能随年龄下降的速度大于不吸烟组。3L ogistic回归分析 :慢性支气管炎患者是否患有 COPD与年龄、低体质指数、呼吸道症状与体征有关系 ,吸烟组与年龄和性别关系更为密切 ,而不吸烟组与临床症状和体征更为密切。结论不是所有慢性支气管炎患者都患有 COPD,吸烟、年龄大、病程长是 COPD的易患因素 ,吸烟可以加速病情进展 ,呼吸症状和体征有助于鉴别是否已患有 COPD。控制吸烟和早期治疗慢性支气管炎对 COPD的预防具有重要的意义。

Objective To observe the prevalence and clinical characteristics of COPD in non-smoking and smoking patients with chronic bronchitis. Methods A cross-section survey was carried out on 952 non-smokers and 1 143 smokers both with chronic bronchitis from 102 230 rural people in 1992.Results The prevalence of COPD for non-smokers was 37.7%,less than 43.1% for smokers (P=0.009).It increased with age more quickly in smkeres. After adjustment for age,sex and square of height,FVC,FEV 1 and FEV 1/FVC were significant inverse to years of cough in both groups.However,their rates of decline with age were significantly lower in non-smokers. Multiple Logistic analysis showed that COPD was significantly associated with age, sex,lower BMI(≤23 kg/m 2)and respiratory symptoms and signs.However,the effects of sex and age were greater in smokers while the effects of respiratory symptom and signs were greater in non-smokers.Conclusion Elder,male,smoking,more years with cough are significantly associated with COPD.Respiratory symptoms and signs might be helpful to distinguish the patients with COPD.