厦门市海沧区慢性阻塞性肺疾病高危人群筛查及危险因素分析

Screening for high-risk individuals of chronic obstructive pulmonary disease and risk factor analysis in Haicang district of Xiamen

目的分析厦门市海沧区居民慢性阻塞性肺疾病(慢阻肺)高危人群比例及危险因素。方法该研究为横断面研究。于2023年2—5月采用整群抽样法向厦门市海沧区全部5家社区卫生服务中心就诊或体检居民发放自行设计的一般资料调查表、慢阻肺人群筛查问卷(COPD-PS)和慢阻肺筛查问卷(COPD-SQ)。将COPD-PS量表≥5分或COPD-SQ量表≥16分的人群定义为慢阻肺高危人群。使用Pearsonχ^(2)检验、趋势卡方检验和二元logistic回归分析慢阻肺高危与非高危人群在性别、年龄、吸烟、慢阻肺家族史、既往肺结核病史、既往新型冠状病毒感染史、生物质材料暴露等方面的差异,并分析慢阻肺高危的影响因素。结果共发放问卷4260份,回收4221份有效问卷,回收率为99.6%。其中,男性1904名(45.11%),女性2317名(54.89%);60~<70岁者占比最多2194名(51.98%)。269名(6.4%)居民COPD-PS量表得分≥5分,534名(12.7%)居民COPD-SQ量表得分≥16分,COPD-PS量表得分≥5分或COPD-SQ量表得分≥16分的慢阻肺高危人群有646名(15.3%)。男性(OR=2.592,95%CI:2.135~3.146)、二手烟接触史(OR=3.763,95%CI:2.944~4.810)、14岁前经常感冒(OR=3.804,95%CI:2.927~4.944)、肺结核病史(OR=2.575,95%CI:1.224~5.418)、高血压(OR=1.547,95%CI:1.277~1.875)和糖尿病(OR=1.791,95%CI:1.027~3.121)均是高危慢阻肺的独立危险因素(均P<0.05),而新型冠状病毒感染史(OR=0.583,95%CI:0.476~0.714)是高危慢阻肺的阻碍因素(P<0.05)。结论男性、有二手烟接触、14岁前经常感冒、肺结核病史、高血压和糖尿病是慢阻肺高危人群的危险因素,而新型冠状病毒感染史是高危慢阻肺的阻碍因素。

Objective To screen high-risk population of chronic obstructive pulmonary disease(COPD)and to analyze the risk factors in Haicang District of Xiamen City.Methods A questionnaire survey was conducted from February 2023 to May 2023 among residents who visited or underwent physical examinations at five community health service centers in Haicang District of Xiamen City selected by cluster sampling method.The self-designed general information questionnaire,COPD population screening questionnaire(COPD-PS)and COPD screening questionnaires(COPD-SQ)were applied in the survey.Individuals with COPD-PS scale>5 or COPD-SQ scale>16 were defined as COPD high-risk group.The association of COPD risk with gender,age,smoking,family history of COPD,history of tuberculosis,history of COVID-19 infection,and using coal/woodstove for cooking or heating was analyzed with chi-square test and binary logistic regression analysis.Results A total of 4260 questionnaires were distributed and 4221 valid questionnaires were collected with a recovery rate of 99.6%.Among all respondents there were 1904 males(45.11%)and 2317 females(54.89%);and 217 individuals aged 40-<50(5.14%),434 aged 50-<60(10.28%),2194 aged 60-<70(51.98%),1302 aged 70-<80(30.85%)and 74 aged≥80(1.76%).The results showed that there were 269 respondents(6.4%)scored≥5 on the COPD-PS scale,534 residents(12.7%)scored≥16 on the COPD-SQ scale,646(15.3%)scored≥5 on the COPD-PS scale or≥16 on the COPD-SQ scale.Male gender(OR=2.592,95%CI:2.135-3.146),second-hand smoke exposure(OR=3.763,95%CI:2.944-4.810),frequently catching cold before the age of 14(OR=3.804,95%CI:2.927-4.944),history of tuberculosis(OR=2.575,95%CI:1.224-5.418),hypertension(OR=1.547,95%CI:1.277-1.875),and diabetes(OR=1.791,95%CI:1.027-3.121)were independently associated with the high-risk of COPD,while the history of COVID-19(OR=0.583,95%CI:0.476-0.714)was a protective factor for COPD risk.Conclusion Males,exposure to second-hand smoke,frequently catching cold before the age of 14,history of tuberculosis,hypertension,and diabetes will increase the risk of COPD,while the history of COVID-19 is a protective factor.