辽宁省40岁及以上居民慢性阻塞性肺疾病患病情况及影响因素分析

Morbidity and influencing factors of chronic obstructive pulmonary disease in residents(≥40 years old)of Liaoning Province

目的了解辽宁省40岁及以上居民慢性阻塞性肺疾病(COPD)患病现状及影响因素,为辽宁省制定COPD防控策略提供理论依据。方法于2019年11月—2020年5月,采用多阶段分层整群随机抽样方法,选取辽宁省沈阳市新民市、辽宁省本溪市明山区、辽宁省丹东市东港市、辽宁省阜新市海州区4个监测点40岁及以上常住居民作为研究对象,进行问卷调查、体格检查与肺功能检查。应用SPSS 27.0软件,采用复杂抽样和加权率的估计方法分析COPD患病率,应用基于复杂抽样设计Rao-Scottχ^(2)检验以及Fisher’s精确检验比较不同特征人群COPD患病率的差异,采用多因素logistic回归分析COPD患病的影响因素。结果2110名研究对象中COPD患者283人,COPD调整患病率为14.00%。多因素logistic回归分析结果显示,年龄≥60岁(与40~49岁相比,OR_(60~69岁)=4.682,95%CI:2.540~8.630、OR≥70岁=6.974,95%CI:3.603~13.499)、吸烟情况(与从不吸烟相比,OR_(现在吸烟)=2.826,95%CI:1.858~4.300、OR_(既往吸烟)=3.377,95%CI:2.457~4.641)、个人呼吸系统疾病史(OR=3.115,95%CI:2.250~4.313)、呼吸系统疾病家族史(OR=1.868,95%CI:1.384~2.522)与辽宁省40岁及以上居民COPD患病高风险相关;大专及以上文化程度(OR=0.440,95%CI:0.227~0.890)、职业为技术人员(OR=0.258,95%CI:0.107~0.621)和离退休人员(OR=0.631,95%CI:0.417~0.956)、超重(OR=0.698,95%CI:0.510~0.955)与肥胖(OR=0.663,95%CI:0.448~0.983)与COPD患病低风险相关,均有统计学意义(P<0.05,P<0.01)。结论辽宁省40岁及以上居民COPD患病率较高,应重视健康宣传教育,特别加强吸烟、高龄、低文化程度、有个人及家族呼吸系统疾病史、低体质指数居民的COPD防控。

Objective To understand the morbidity and influencing factors of chronic obstructive pulmonary disease(COPD)in residents(≥40 years old)in Liaoning Province,and provide the theoretical basis for the formulation of COPD prevention and control strategies in Liaoning Province.Methods From November 2019 to May 2020,the multi-stage stratified random cluster sampling method was used to select the permanent residents(≥40 years old)from four monitoring sites(Xinmin city of Shenyang,Mingshan district of Benxi,Donggang city of Dandong and Haizhou district of Fuxin)of Liaoning Province as the subjects.The investigation was performed with the questionnaire,physical examination and pulmonary function test.Estimation methods for complex sampling and weighting rates was used to analyze the COPD morbidity.The Rao-Scottχ^(2) test based on the complex sampling design and the Fisher's exact test were used to compare the difference of COPD morbidity among residents with different characteristics.Multivariate logistic regression analysis was used to analyze the influencing factors of COPD morbidity.The used software was SPSS 27.0.Results Among the 2110 subjects,the adjusted morbidity of COPD was 14.00%(283 cases).Multivariate logistic regression analysis showed that subjects≥60 years old(as compared with 40-49 years old,OR_(60-69)=4.682,95%CI:2.540-8.630;OR≥70=6.974,95%CI:3.603-13.499),smoking(as compared with no-smoking,OR_(current smoking)=2.826,95%CI:1.858-4.300;OR_(previoussmoking)=3.377,95%CI:2.457-4.641),personal history of respiratory system diseases(OR=3.115,95%CI:2.250-4.313)and family history of respiratory system disease(OR=1.868,95%CI:1.384-2.522)correlated to the high risk of COPD in residents(≥40 years old)in Liaoning Province;higher education level(compared with≤primary school level,OR≥college level=0.440,95%CI:0.227-0.890),technical personnel(OR=0.258,95%CI:0.107-0.621),retired personnel(OR=0.631,95%CI:0.417-0.956),overweight(OR=0.698,95%CI:0.510-0.955)and obesity(OR=0.663,95%CI:0.448-0.983)correlated to the low risk of COPD in residents(≥40 years old)in Liaoning Province.Conclusion The COPD morbidity in residents(≥40 years old)in Liaoning Province is higher.It should pay attention to the health publicity and education,and strengthen specially the COPD prevention and treatment for residents with smoking,high age,low education level and personal or family history of respiratory system diseases.