慢性阻塞性肺疾病及其严重程度相关的危险因素分析

Analysis of risk factors related to chronic obstructive pulmonary disease and its severity

目的分析慢性阻塞性肺疾病(COPD)及其严重程度的相关危险因素,以便在公共卫生决策和临床诊疗过程中及早进行干预,提高患者生活质量,降低COPD的发病率和死亡率。方法采取病例对照研究方法,收集空军军医大学西京医院2020年12月至2021年10月确诊为COPD的患者168例,设为病例组,同期拟行外科手术并排除呼吸系统疾病的患者154例设为对照组,采用二元logistic回归分析模型,分析COPD危险因素的OR及95%CI,采用Kruskal-Wallis H检验分析与疾病严重程度相关的危险因素。结果吸烟史、长期使用煤炭和柴草、工作接触粉尘史及父母呼吸道慢性疾病史是主要危险因素,体质量指数、开始吸烟年龄、出现呼吸道症状时间、合并哮喘以及是否使用吸入性药物治疗与COPD的严重程度相关,燃料类型、吸氧与改良呼吸困难指数相关,燃料类型及居住房屋类型与生活质量评估测试评分相关。结论戒烟、使用清洁燃料、职业接触中重视防护可预防COPD,较晚开始吸烟、出现症状及时治疗、增强营养可减缓肺功能下降,改善居住环境及使用清洁燃料可改善患者的症状及生活质量。

Objective To analyze the risk factors related to chronic obstructive pulmonary disease(COPD)and its severity,so as to provide early intervention in the process of public health decision-making and clinical diagnosis and treatment,improve patients quality of life,and reduce the incidence and mortality of COPD.Methods A case-control study was performed in 168 patients diagnosed with COPD from December 2020 to October 2021 in Xijing Hospital of Air Force Medical University and 154 controls who planned to receive surgery and had no respiratory diseases during the same period.Binary logistic regression analysis model was used to analyze the OR and 95%CI of risk factors related to COPD.Kruskal-Wallis H was used to analyze the risk factors related to the severity of COPD.Results Smoking history,indoor exposure to coal and straw for cooking or heating,exposure to dust in the workplace and family history of chronic lung disease were the main risk factors of COPD.Body mass index,age of smoking initiation,time of onset of respiratory symptoms,being complicated with asthma and whether to use inhaled medications were associated with the severity of COPD.Fuel type and oxygen intake were correlated with modified Medical Research Council dyspnea scale;fuel type and housing type were correlated with COPD assessment test.Conclusion Quitting smoking,using clean fuels,and paying attention to protection during occupational exposure can prevent the occurrence of COPD.Starting smoking at an older age,giving timely treatment when symptoms occur and enhancing nutrition can prevent further decline of lung function in COPD patients,and at the same time,improving living conditions and using clean fuels can improve patients quality of life.