目的：调查北京市西城区慢性阻塞性肺疾病( COPD）患病情况，并探究其发生的危险因素，以利于社区卫生服务机构对该疾病进行早期干预和规范诊疗。方法2014年7月—2015年7月采用分层整群抽样方法抽取北京市西城区15个街道，按照每个街道内人数占西城区总人数的构成比抽取符合纳入标准的1125例居民作为调查对象。检测居民的肺功能指标，以吸入支气管舒张剂后第1秒用力呼末气容积( FEV1）／用力肺活量( FVC）＜70％作为COPD的判断标准。并对居民进行问卷调查，问卷内容主要包括基础资料〔性别、年龄、体质指数( BMI）、受教育水平、家庭人均年收入〕、生存因素(吸烟、使用煤／柴等固定燃料、职业粉尘接触史、呼吸系统疾病史、 COPD家族史、感冒次数）、症状(咳嗽、气促）。结果共发放问卷1125份，回收有效问卷904份，有效应答率80.4％。本次调查共发现COPD患者75例， COPD患病率为8.3％(75／904）。不同性别、年龄、受教育水平、家庭人均年收入居民COPD患病率比较，差异有统计学意义(P＜0.05）。吸烟、使用煤／柴等固体燃料、有职业粉尘接触史、有呼吸系统疾病史、有COPD家族史的居民COPD患病率高( P＜0.05）；不同感冒次数的居民COPD患病率比较，差异有统计学意义(P＜0.05）。将吸烟者按照吸烟指数(SI）＜200支・年、200支・年≤SI＜400支・年和SI≥400支・年进行划分， SI＜200支・年居民COPD患病率低于SI≥400支・年居民( P＜0.05）。有咳嗽、气促症状的居民COPD患病率高( P＜0.05）。多因素Logistic 回归分析结果显示，年龄〔OR ＝1.044，95％CI (1.014，1.074）〕、吸烟〔OR ＝5.485，95％CI (2.657，11.322）〕、使用煤／柴等固体燃料〔OR＝1.731，95％CI (1.012，2.962）〕、有职业粉尘接触史〔OR＝2.407，95％CI (1.358，4.267）〕、有呼吸系统疾病史〔OR＝2.455，95％CI (1.409，4.279）〕是居民发生COPD的独立危险因素(P＜0.05）。结论北京市西城区COPD患病率为8.3％，且年龄、吸烟、使用煤／柴等固体燃料、有职业粉尘接触史、有呼吸系统疾病史是居民发生COPD的独立危险因素。%Objective To investigate prevalence of chronic obstructive pulmonary disease ( COPD ) in Xicheng District, Beijing, and explore risk factors of its occurrence , so as to facilitate early intervention and standardized diagnosis and treatment of the disease in community health service institutions .Methods From July 2014 to July 2015, stratified cluster sampling method was used to extract 15 streets in Xicheng District , Beijing, and 1 125 residents were enrolled as research objects according to the constituent ratio of the population in each street in the total population of Xicheng District .The pulmonary function indices of residents were detected and the ratio of forced expiratory volume in 1 second (FEV1 ) /forced vital capacity (FVC)that less than 70% after inhaling bronchodilators was taken as the diagnostic criterion of COPD .The questionnaires were sent toresidents for investigation.The contents of questionnaires included basic data 〔gender, age, body mass index ( BMI),educational level, annual family income per capita 〕, survival factors (smoking, using coal and biofuels, occupational dustexposure history, history of respiratory system disease , COPD family history, times of catching cold), and symptoms (cough,shortness of breath) .Results A total of 1 125 questionnaires were issued, and 904 were recovered with an effective responserate of 80.4%.Seventy -five residents were diagnosed with COPD and the prevalence rate was 8.3% (75/904) .There weresignificant differences in the prevalence of COPD in residents with different gender , age, educational degrees and annual familyincome per capita (P <0.05) .The prevalence of COPD was significantly high in residents who smoked , had used coal andbiofuels, had occupational dust exposure history , history of respiratory system disease and COPD family history (P <0.05);there was significant difference in the prevalence of COPD among residents with different times of catching cold (P <0.05).Smokers were divided into groups according to their SI (SI <200 pack -year, 200 pack -year≤SI <400 pack -year and SI≥ 400 pack -year) .The prevalence rate of COPD in smokers with SI <200 pack -year was lower than that in those with SI ≥400pack -year (P <0.05) .The prevalence of COPD was significantly high in residents with symptoms of cough and shortness ofbreath (P <0.05) .The results of multivariate Logistic regression analysis showed that age 〔OR =1.044, 95%CI (1.014,1.074)〕, smoking 〔OR =5.485, 95%CI (2.657, 11.322)〕, using coal and biofuels 〔OR =1.731, 95%CI (1.012,2.962)〕, having occupational dust exposure history 〔OR =2.407, 95%CI (1.358, 4.267)〕and history of respiratory systemdisease 〔OR =2.455, 95%CI (1.409, 4.279)〕were the independent risk factors for residents developing COPD (P <0.05).Conclusion The prevalence rate of COPD in Xicheng District is 8.3%.Age, smoking, using coal and biofuels,having history of occupational dust exposure and of respiratory system disease are the independent risk factors for residentsdeveloping COPD.
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