新疆墨玉县乡村地区慢性阻塞性肺疾病患病现况及影响因素分析

Prevalence and influencing factors of chronic obstructive pulmonary disease in rural areas of Moyu County,Xinjiang

目的分析中国新疆维吾尔自治区和田地区墨玉县乡村地区慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)现况及影响因素,为当地该病的早期预防和选择干预策略提供科学依据。方法选择中国西北区域自然人群队列研究中新疆乡村地区的基线调查人群为研究对象。2018年6-12月在维吾尔自治区和田地区墨玉县乡村地区对35岁及以上自然人群进行现场调查,完成受试者调查问卷、体格检查和肺功能测量等数据的收集,最终获得有效样本3 249份。采用Stata 13.0软件进行χ^(2)检验、趋势χ^(2)检验,采用单因素及多因素二分类Logistic回归分析相关调查因素与COPD患病的关系。结果当地共有394例(12.13%)受试者被诊断为COPD。40岁以上调查人群COPD患病率为12.59%(95%CI:11.45%~13.83%),并且随年龄增长而增加(趋势χ^(2)=71.990;P<0.001)。其中40岁以上人群中男性患病率(15.3%)显著高于女性(10.1%),差异具有统计学意义(χ^(2)=14.216;P <0.001)。在控制混杂因素后,多因素Logistic回归分析结果显示:高龄(50~<60岁:OR=1.800,95%CI:1.203~2.694;60~<70岁:OR=3.035,95%CI:1.986~4.637;≥70岁:OR=5.602,95%CI:2.419~12.973)、主动吸烟(OR=1.422,95%CI:1.077~1.877)、使用传统生物燃料或煤(OR=2.258,95%CI:1.022~4.991)、有肺结核病史(OR=2.181,95%CI:1.291~3.682)是当地COPD患病的危险因素。较高水平BMI (24.0~<28.0:OR=0.611,95%CI:0.449~0.830;≥28.0:OR=0.470,95%CI:0.258~0.858)和使用通风装置(OR=0.666,95%CI:0.473~0.937)的人群患COPD的风险较低。结论中国新疆墨玉县乡村地区COPD患病率为12.13%,与国内报道数据基本一致。除高龄、吸烟以外,使用煤或传统生物质作燃料、缺少通风装置以及有肺结核病史与当地COPD患病风险密切相关。

Objective To analyze the status and influencing factors of chronic obstructive pulmonary disease(COPD) in rural areas of Moyu County,in the southern part of Xinjiang,and to provide scientific basis for early prevention and intervention strategies.Methods The baseline survey population in rural Xinjiang of the Natural Population Cohort Study in Northwest China was selected as the research object.A field survey was conducted from June to December 2018 in the rural areas of Moyu County,among the natural population aged 35 to 74, and the results of a questionnaire, physical examination and lung function measurement were collected.Finally,3 249 valid samples were obtained.Stata 13.0 software was used for Chisquare test and trend Chi-square test.Univariate and multivariate binary logistic regression were adopted to analyze the correlation between related investigation factors and COPD.Results A total of 394 subjects(12.13%) were diagnosed with COPD.The prevalence of COPD was 12.59%(95% CI: 11.45% ~ 13.83%) in subjects over 40 years old,it was increased with age(Chi-square trend = 71.990,P<0.001),and that of men was significantly higher than that of women(15.3% vs 10.1%,Chi-square = 14.216,P < 0.001).After controlling confounding factors,multivariate logistic regression analysis showed that advanced age(50 ~ < 60 years old: OR = 1.800,95%CI: 1.203 ~ 2.694;60 ~ <70 years old: OR = 3.035,95%CI: 1.986 ~ 4.637;≥70 years old: OR = 5.602,95%CI: 2.419 ~ 12.973),active smoking(OR = 1.422,95% CI: 1.077 ~ 1.877),use of traditional biofuels or coal(OR = 2.258,95%CI: 1.022 ~ 4.991),and a history of tuberculosis(OR = 2.181,95%CI: 1.291 ~ 3.682) were independent risk factors for local COPD.People with higher BMI(24.0 ~ <28.0: OR= 0.611,95%CI: 0.449 ~ 0.830;≥28.0: OR = 0.470,95% CI: 0.258 ~ 0.858) and using ventilation devices(OR = 0.666,95%CI: 0.473~0.937) had a lower risk of COPD.Conclusion The prevalence of COPD in rural areas of Moyu County is 12.13%,basically consistent with the domestic reports.In addition to the common risk factors like advanced age and smoking,the use of traditional biofuels or coal,lack of ventilation,and a history of tuberculosis are also closely associated with the risk of local COPD.