维吾尔族人群慢性阻塞性肺疾病病因研究

Uighur people cause chronic obstructive pulmonary disease research

目的研究维吾尔族人群慢性阻塞性肺疾病(COPD)的病因、患病率和危险因素。方法 2013年1月-2015年10月采用统一的流行病学调查表,以整群随机抽样方法抽取喀什市5个社区40岁以上维吾尔族及汉族常住居民进行问卷调查及肺功能检测,以吸入支气管舒张剂后,第1秒用力呼气容积(FEV1)/用力肺活量(FVC)(FEV1/FVC)<70%,并通过询问病史,X线胸片和心电图检查排除其他可能导致肺功能损害的心肺疾病作为COPD的诊断标准,共抽取1 311人,实际调查人数1 284人,应答率97.9%,平均年龄(57±14)岁。结果 COPD总患病率6.6%(85/1284),其中男性患病率(7.5%)显著高于女性(5.5%);维吾尔族人群COPD患病率(7.1%)显著高于汉族(5.6%);吸烟者COPD患病率(10.9%)显著高于不吸烟者(5.0%),烹饪取暖燃料为煤碳、木柴、生物燃料及有厨房行为者患病率(7.5%)显著高于非烹饪取暖燃料为煤碳、木柴、生物燃料及没有厨房行为者(5.2%),厨房无排气装置,且厨房通气不良者患病率(7.1%)显著高于有排气装置者(5.0%),职业接触粉尘者患病率(9.0%)显著高于非接触者(6.5%),有呼吸系统疾病史者患病率(13.2%)显著高于无呼吸系统疾病史者(5.1%),差异有统计学意义(P<0.05)。结论吸烟、烹饪取暖燃料为煤碳、木柴、生物燃料及有厨房行为,厨房无排气装置且厨房通气不良,职业接触粉尘,呼吸系统疾病史等是喀什市社区居民维吾尔族人群COPD患病的主要危险因素,应针对危险因素采取综合干预措施降低患病率。

To investigate pathogenesis, prevalence and risk factors of chronic obstructive pulmonary disease（COPD） of the Uighur population. 【Methods】From January 2013 to October 2013, adopted unified epidemiological survey, using cluster random sampling method to make a survey of 1284 elder than 40 Uighur and Han residents of 5 community of Kashgar. The gold standards diagnosis of COPD were pulmonary function test, medical history, X-ray chest and electrocardiogram examination to rule out other lung diseases caused by heart diseases. 【Results】The total prevalence rate of COPD was 6.6%（85/1 284）; The prevalence rate of male who suffered COPD（7.5%） was significantly higher than female（5.5%）; The prevalence rate of Uighur population with COPD（7.1%） was significantly higher than Han nationality（5.6%）; The prevalence rate of smokers with COPD（10.9%） was significantly higher than nonsmokers（5.0%）; The prevalence rate of who cooking and keeping warm using biofuels and having kitchen behavior suffered COPD（7.5%） was significantly higher than who without these behaviours（5.2%）; The prevalence rate of whose kitchen without exhaust system（7.1%, 71/1004） was significantly higher than whose with exhaust system（5.0%）; The prevalence rate of who with occupational exposure to dust was（9.0%） is significantly higher than who without occupational exposure to dust（6.5%）; The prevalence rate of who with a history of respiratory system disease（13.2%） was significantly higher than who without history of respiratory disease（5.1%）; There were both significant differences of the differences（P〈0.05）. 【Conclusion】Smoking, cooking and keeping warm with biofuels, kitchen behaviors, kitchen without exhaust system, occupational exposure to dust and history of respiratory diseases were major risk factors for Uighur community residents with COPD in Kashgar. We should adopt comprehensive intervention measures to avoid these risk factors to reduce the prevalence rate of COPD.