非吸烟人群慢性阻塞性肺疾病相关因素Logistic回归分析

Logistic regression analysis of chronic obstructive pulmonary disease related factors in non-smokers

目的:探讨非吸烟人群慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)的相关因素,为制定早期筛查指标提供依据。方法:从南京医科大学第一附属医院健康管理中心和呼吸内科共招募2 440例30岁以上既往无COPD确诊史的非吸烟人群为调查对象,采用问卷调查收集相关因素,应用症状结合肺功能检测诊断COPD。组间比较连续变量采用独立样本t检验,类别变量采用卡方检验或Kruskal-Wallis H检验,关联强度采用Logistic回归模型估计并用OR(95%CI)表示。结果:单因素Logistic回归分析校正年龄性别后,文化程度低、低收入、居住在农村或郊区、长期接触粉尘或化学毒物、长期接触生物燃料或油烟等室内空气污染、儿童期有慢性呼吸道疾病史、天气变化时经常咳嗽、喘憋、活动后易气短与COPD关联具有统计学意义。多因素逐步回归分析显示,年龄60岁及以上、体重指数(BMI)较低、儿童期有慢性呼吸道疾病史、长期接触粉尘或化学毒物、不感冒时经常咳嗽、喘憋、活动后易气短与COPD的关联具有统计学意义。结论:年龄60岁及以上、BMI较低、儿童期有慢性呼吸道疾病史、长期接触粉尘或化学毒物、不感冒时经常咳嗽、喘憋、活动后易气短与非吸烟人群COPD有关,可针对具有这类特征的人群开展早期筛查和干预。

Objective:This study aims to explore the related factors of chronic obstructive pulmonary disease(COPD)in non-smokers,and provide a basis for the development of early screening indicators. Methods:A total of 2 440 non-smokers above 30 years old without history of COPD were recruited from the Health Management Center and Department of Respiratory Medicine of the First Affiliated Hospital with Nanjing Medical University. Questionnaires were used to collect related factors. Symptoms combined with lung function test were used to diagnose COPD. The independent-sample t test was used to compare continuous variables between groups,and the chi-square test or Kruskal-Wallis H test was used for categorical variables,and the correlation strength was estimated by logistic regression model and expressed by OR(95% CI). Results:After adjusting for age and gender by single factor logistic regression analysis,low education level,low income,living in rural or suburban areas,long-term exposure to dust or chemical poisons,long-term exposure to indoor air pollution such as bio-fuels or oil fume,history of chronic respiratory diseases in childhood,frequent coughing,wheezing and shortness of breath after activities were significantly associated with COPD. Multivariate stepwise regression analysis showed that age of 60 and above,low BMI,history of chronic respiratory disease in childhood,long-term exposure to dust or chemical toxins,frequent coughing when not having a cold,wheezing,and shortness of breath after activities were significantly associated with COPD. Conclusion:Age of 60 and above,low BMI,history of chronic respiratory diseases in childhood,long-term exposure to dust or chemical poisons,frequent coughing when not having a cold,wheezing,shortness of breath after activities are related to COPD in non-smokers. Early screening and intervention should be carried out for people with such characteristics.