恩施地区居民慢性阻塞性肺疾病急性加重住院情况与气候变化相关性分析

Correlation analysis of acute exacerbation of chronic obstructive pulmonary disease and climate change in Enshi,Hubei Province

目的分析湖北恩施地区居民慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)急性加重住院情况及气候变化的相关性,为湖北恩施地区居民防治COPD提供理论依据。方法选取2019年1~12月湖北恩施地区住院的COPD急性发作患者,统计所有患者临床资料;同时收集同期湖北恩施地区气象因素资料等,采用Spearman直线相关分析影响住院AECOPD患者人数的气象因素。结果湖北恩施地区居民COPD急性加重患者年龄主要集中于70~79岁(34.63%),其次为60~69岁(22.49%),最低为40~49岁(13.75%);发病时间主要集中于3~5月为高峰,11~1月为次高峰,6~10月发病人数相对少;COPD急性加重组主要症状以咳嗽频繁、气促加重、痰量增多等为主,而体征上主要以肺气肿、哮鸣音、干湿啰音为主;COPD急性加重组FEV1%预测值、FEV1/FVC值明显低于非急性加重组(P<0.05);COPD急性加重组血清WBC和CRP水平明显高于非急性加重组(P<0.05);湖北恩施地区月均气温从1月份逐月升高,在8月份达高峰,然后逐月降低,12月份达低谷;月均湿度在7~9月份达高峰;月均风速在11~12月达高峰;月均日照在6~9月份达高峰;Spearman相关分析显示AECOPD月发病入院数与与月均气温、月均湿度呈负相关,相关性系数为(r_(1)=-0.519,r_(2)=-0.428,P<0.05);与月均日照时间和月均风速无直线相关性(r_(1)=0.124,r_(2)=0.176,P>0.05)。结论COPD患者急性加重入院人数表现出明显季节性,对于气温、湿度等变化较大的月份,应积极预防COPD患者急性加重的发生。

Objective To analyze the relationship between acute exacerbation of chronic obstructive disease(COPD)hospitalization and climate change in Enshi,Hubei province,and to provide theoretical basis for the prevention and treatment of COPD in Enshi.Methods Patients with acute COPD in Enshi district of Hubei Province from January 2019 to December 2019 were selected,and the clinical data of all patients on admission,including symptoms,signs,onset month,lung function indicators and serum inflammatory factors,were analyzed.FEV1%predictive value,FEV1/FVC and other lung function indexes were determined by pulmonary function detector.CRP and WBC levels were determined by biochemical detector.At the same time,meteorological factors data in Enshi,were collected,including monthly mean temperature,monthly mean humidity,monthly mean wind speed,monthly mean sunshine in Hubei province,etc.Spearman linear correlation was used to analyze the meteorological factors affecting the number of hospitalized AECOPD patients.Results The age of patients with ACUTE exacerbation of COPD was mainly 70-79 years old(34.63%)in Enshi area of Hubei Province,followed by 60-69 years old(22.49%),and the lowest was 40-49 years old(13.75%).The incidence time mainly concentrated to may for the peak in March,November to January for the secondary peak,June to October for a relatively small number of cases.The main symptoms of COPD acute recombination are frequent cough,shortness of breath,increased sputum volume,etc.,while the main signs are emphysema,wheezing,dry and wet rales.The predictive value of FEV1 and FEV1/FVC value of acute recombinant COPD were significantly lower than those of non-acute recombinant COPD(P<0.05).Serum WBC and CRP levels in COPD acute plus recombinant were significantly higher than those in non-acute plus recombinant(P<0.05).The monthly average temperature in Enshi increased month by month from January,peaked in August,then decreased month by month,and reached a low point in December.The monthly average humidity reaches the peak from July to September.The monthly mean wind speed reaches its peak from November to December.The monthly average sunshine reaches its peak from June to September.Spearman correlation analysis showed that there was a negative correlation between the number of AECOPD patients and monthly average temperature and monthly average humidity,and the correlation coefficient was(r_(1)=-0.519,r_(2)=-0.428,P<0.05).There was no linear correlation with monthly mean sunshine time and monthly mean wind speed(r_(1)=0.124,r_(2)=0.176,P>0.055).Conclusion The number of patients with ACUTE exacerbation of COPD shows obvious seasonality,and the occurrence of AECOPD should be actively prevented in months with great changes in temperature and humidity.