广东省社区40岁及以上慢性阻塞性肺疾病患者肺功能检查和药物治疗情况研究

Analysis of pulmonary function test and medication treatment of patients with chronic obstructive pulmonary disease aged 40 years or older in community of Guangdong Province

目的了解广东省社区40岁及以上慢性阻塞性肺疾病(简称慢阻肺)患者肺功能检查、药物治疗情况及影响因素,为制定本地区有针对性的防控措施,开展慢阻肺健康教育提供理论依据。方法依托2019年一2020年广东省社区居民慢性阻塞性肺疾病监测项目,采用多阶段分层整群随机抽样对3384名调查对象进行了问卷调查和肺功能检查。采用基于复杂抽样设计的Rao-Scott χ^(2)检验、非条件Logistic回归探讨影响慢阻肺患者肺功能检查、药物治疗的可能影响因素。结果3384名调查对象中,确诊慢阻肺患者288例,其中男253例(87.8%),女35例(12.2%);≥60岁患者184例,占全部患者的60.4%。慢阻肺患者的肺功能检查率为10.7%[95%置信区间(confidence interval,CI)6.8%~14.6%]、药物治疗率为10.6%(95%CI7.0%~14.1%)。喘息、慢阻肺相关知识知晓情况和肺功能检查知晓情况与慢阻肺患者是否进行肺功能检查有关(P<0.05);喘息和个人呼吸系统疾病史是慢阻肺患者进行药物治疗的可能影响因素(P<0.05)。结论广东省≥40岁的慢阻肺患者的肺功能检查率及药物治疗率均较低,应积极开展关于慢阻肺的健康教育工作,加强对有呼吸系统疾病史和呼吸道症状人群的监测,以期降低慢阻肺疾病负担。

Objective To investigate the rate of pulmonary function test,medication treatment,and relevant factors among patients with chronic obstructive pulmonary disease(COPD)aged 40 years or older in community of Guangdong Province,and to provide evidences for targeted intervention of COPD.Methods A multistage stratified cluster sampling was conducted in the community residents,who participated in the COPD surveillance project of in Guangdong Province during 2019 to 2020.A total of 3384 adults completed questionnaire and pulmonary function test.The Rao-Scott χ^(2) test based on complex sampling design,and non-conditional Logistic regression were used to explore possible influencing factors of pulmonary function test and medication treatment in COPD patients.Results Out of the 3384 adults,288 patients with COPD were confirmed,including 253 males(87.8%)and 35 females(12.2%),and 184 patients(60.4%)were over 60 years old or more.The pulmonary function test rate was 10.7%[95% confidence interval(CI)6.8%-14.6%],and medication treatment rate was 10.6%(95%CI 7.0%-14.1%).The results showed that wheezing,awareness of COPD related knowledge and pulmonary function test were related to whether COPD patients had pulmonary function test(P<0.05).Wheezing and personal history of respiratory diseases were related to medication treatment rate(P<0.05).ConclusionsThe rates of pulmonary function test and medication treatment among COPD patients aged 40 years or older are low.Health education about COPD should be actively carried out,and the screening of individuals with a history of respiratory diseases and respiratory symptoms should be strengthened so as to reduce the burden of COPD diseases.