社区居民第一秒用力呼气容积下降的危险因素分析

Risk factors of FEV1 decline in community residents

目的探讨在一般人群中影响第1秒用力呼气容积(FEV1)下降速度的相关因素。方法在山西省太原市晋源区社区卫生服务中心招募35岁以上居民进行问卷调查、体格检查、肺功能筛查,随访1.5年观察FEV1下降速度及其可能的危险因素。结果纳入研究对象共436人,其中男性249人,女性187人,平均年龄(54±10)岁。18例调查者FEV1无明显下降,418例调查者肺功能均出现了FEV1下降趋势,FEV1的年均下降量(38±11)ml;初筛慢性阻塞性肺疾病患者的FEV1年均下降量约(48±10)ml。吸烟者年均FEV1下降量(49±13)ml,不吸烟者(31±9)ml,两者之间差异有统计学意义(P<0.05)。Logistic多因素回归分析提示吸烟、体质量指数、慢性咳嗽、糖尿病、心血管疾病是影响FEV1下降的主要危险因素,其中吸烟是加速FEV1下降的独立危险因素。结论在社区居民中定期监测肺功能不仅利于慢性阻塞性肺疾病的早防早治,同时有利于预测心血管系统疾病、糖尿病的发展趋势。

Objective To investigate factors that relate to the rate of decline in forced expiratory volume in firstsecond(FEV1)in the general population.Methods Enrolled in this study were residents aged above 35 years old in a community healthcare service center of Jinyuan District,Taiyuan,Shanxi Province.The subjects underwent ques-tionnaire surveys,physical checkup,and lung function screening.During the 1.5-year follow up,the rate of FEV1 decline rate and its possible risk factors were investigated.Results A total of 436 subjects were included in the study,comprising 249 males and 187 females,with a mean age of(54±10)years.Except for 18 interviewees,there was a significant trend of FEV1 decline among 418 others.The mean annual decrease in FEV1 was(38±11)ml in all subjects,(48±10)ml in those found to have COPD by primary screening,(49±13)ml in smokers and(31±9)ml in non-smokers.These differences were statistically significant(P<0.05).Multivariate Logistic regression analysis suggested that smoking,body mass index,chronic cough,diabetes,and cardiovascular disorders were major risk factors that affected the FEV1 decline.Among these,smoking was an independent risk factor that may accelerate the decline in FEV1.Conclusion Regular monitoring of lung function among community residents is beneficial for early prevention and treatment of COPD;not only so,it helps predicting the risk of cardiovascular disorders and diabetes.