山东省枣庄市农村地区40岁以上人群慢性阻塞性肺疾病患病率调查

摘要

目的 调查枣庄市农村地区40岁以上人群中慢性阻塞性肺痰病(COPD)的患病率和危险因素.方法 采取分层随机整群抽样调查方法,于2003年8月至2003年11月,对本市6个调查点(6个辖区)40岁以上人群进行COPD流行病学调查,实检人口4047人.通过问诊、体检、肺功能测试和胸透等方法诊断,诊断标准参照2002年全国COPD诊治指南.结果 枣庄市农村地区COPD总体患病率为8.57%.多因素分析显示,COPD的危险因素主要有年龄大(OR=5.95,95%CI:4.52～7.84,P<0.01),文化程度低(OR=4.04.95%CI:2.84～5.74,P<0.01),空气污染(OR=4.46,95%CI:2.71～7.32,P<0.01),吸烟(OR=3.04,95%CI:2.42～3.80,P<0.01),幼时经常咳嗽(OR=2.39,95%CI:1.63～3.50,P<0.01),有呼吸系统疾病家族史(OR=1.96,95%CI:1.54～2.48,P<0.01),男性(OR=2.71,95%CI:2.15～3.42,P<0.01),使用生物燃料(OR=1.81,95%CI:1.32～2.48,P<0.01),厨房通风差(OR=1.90,95%CI:1.42～2.55,P<0.01).结论 COPD是严重危害枣庄市农村地区公众健康的疾病,其危险因素呈多样化,应注意加强防治.%Objective To investigate the prevalence rate and risk factors of chronic obstructive pulmonary disease (COPD) among people aged over 40 years in Zaozhuang rural area. Methods By using a stratified random cluster sampling method, the COPD epidemic research on people aged over 40 years was carried out in six investigative places (six jurisdictions) on August to November in 2003 (total 4047 people were investigated). By interrogation, physical examination, lung function test, and chest fluoroscopy, a diagnosis of COPD was made according to guide for diagnosis and treatment of chronic obstructive pulmonary disease. Results The average prevalence of COPD in Zaozhuang rural area was 8.57%. Logistic regression model was conducted, and statistical association of COPD was found with older ( OR = 5.95,95%CI:4. 52 - 7.84,P <0.01 ), lower educational level ( OR = 4. 04,95%CI:2. 84 - 5.74,P < 0. 01 ), air pollution ( OR = 4. 46,95%CI:2.71 - 7.32,P < 0. 01 ), smoking (OR =3.04,95%CI:2.42- 3.80,P <0. 01), frequent coughing during childhood (OR = 2.39,95% CI: 1.63 - 3.50 ,P <0.01 ), family history of respiratory diseases ( OR = 1.96,95% CI: 1.54 - 2. 48,P < 0.01), male ( OR = 2.71,95%CI:2. 15 - 3.42,P <0.01), biomass fuel ( OR = 1.81,95%CI:1.32 -2. 48,P < 0. 01 ), worse ventilation in kitchen room ( OR = 1.90,95%CI:1.42 - 2. 55,P <0. 01 ). Conclusions The epidemic status of COPD is serious in Zaozhuang rural area. The prevalence of COPD is associated with multiple factors and prevention of COPD is warranted.