新疆喀什地区COPD危险因素的病例—对照研究
发布时间：2018-08-03 09:41
【摘要】：目的：分析新疆喀什地区慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)的相关危险因素,以及COPD患者生活质量的影响因素；为新疆喀什地区COPD的防治和制定相应的健康政策和策略提供科学依据。方法：本研究采用以医院为基础的病例对照研究方法,用统一的调查表对病例及对照的病历资料进行调查。病例来源于2011年3月到2012年6月在新疆喀什地区第二人民医院经诊断符合慢性阻塞性肺疾病全球防治倡议(Global Initiative for Chronic Obstructive Lung Disease,GOLD)诊断标准COPD患者。从同期在喀什地区第二人民医院非呼吸科就诊患者中,选择同性别、族别、年龄与COPD患者相差在5岁以内,无慢性呼吸系统及严重心、肝、肾疾病者作为对照。调查内容参考GOLD委员会疾病COPD负担研究专题的流行病学调查问卷,考虑喀什地区文化背景和人文素质进行语言调整,内容包括人口学基本资料、家族肺部疾病史、吸烟和被动吸烟暴露、粉尘接触、厨房通风、燃料、有无抽油烟机、营养状况、饮食习惯等25个项目及数个子项目。运用COPD Assessment Test(CAT)量表对COPD患者的生活质量进行评价,并分析其影响因素。所有数据均使用Epi Data软件进行录入和管理。应用SPSS20.0软件进行统计分析。采用单因素非条件Logistic回归分析和多因素非条件Logistic回归分析确定各种危险因素与喀什地区人群COPD发生的相关性,以优势比(OR)及其95%置信区间(95%CI)表示；所有检验均采用双尾和a0.05水平为有统计学意义。 结果：共有256例患者参与本研究,其中汉族42例(16.4%),维吾尔族214例(83.6%),病例组和对照组各128例,每组均为汉族21例(16.4%)、维吾尔族107例(83.6%)。平均年龄(63.3±10.1)岁,其中病例组组为(62.7±10.5)岁,对照组为(64.0±9.7)岁,两组的性别、年龄、文化程度等人口特征构成均无统计学差异(p0.05)。单因素分析结果显示：BMI、营养状况、烧煤烧柴指数、冬季采暖方式、粉尘接触、厨房控油烟装置、厨房通风、吸烟、家庭被动吸烟、工作场所被动吸烟、呼吸道疾病家族史共计11个因素与COPD发病有关(p0.05)。多因素分析结果显示：营养不良(OR=6.4,95%CI：3.3-8.7)、高烧煤烧柴指数(OR=7.6,95%CI：3.7-9.3)、吸烟(OR=6.5,95%CI：1.9-22.2)、家庭被动吸烟(OR=2.2,95%CI：1.5-10.0)和工作场所被动吸烟(OR=8.2,95%CI：1.2-56.6)、粉尘接触是COPD发病的主要危险因素；厨房通风是COPD发病的保护因素。多因素线性回归模型分析结果显示：烧煤烧柴指数(β=1.973,95%CI：0.126-3.820)、粉尘接触(β=2.982,95%CI：0.956-5.009)、和吸烟(β=1.557,95%CI：0.374-3.487)与CAT得分呈正相关(p0.05),厨房通风(β=-2.314,95%CI：-3.546--1.081)、FEV1%(β=-0.082,95%CI：-0.144--0.021)和FEV1/FVC(β=-0.126,95%CI：-0.234--0.081)与CAT呈负相关(p0.05)。 结论：烧煤烧柴指数、粉尘接触是新疆喀什地区COPD发生的环境危险因素,而且与患者的生活质量具有重要影响,特别是粉尘接触与COPD患病呈现剂量反应关系；吸烟和被动吸烟是新疆喀什地区居民COPD发病的行为危险因素,而且对患者的肺功能和生活质量有影响；营养状况与COPD患病风险呈正相关,是COPD发病的危险因素；厨房通风不但是COPD发病的保护因素,而且厨房通风良好有助于提高患者的生活质量。
[Abstract]:Objective: to analyze the related risk factors of chronic obstructive pulmonary disease (Chronic Obstructive Pulmonary Disease, COPD) in Kashi, Xinjiang, and the influencing factors of the quality of life of COPD patients; to provide scientific basis for the prevention and control of COPD in Kashi region of Xinjiang and the formulation of corresponding health policies and Strategies. The basic case control study was conducted using a unified questionnaire to investigate the case and control data. The cases were diagnosed by the Global Initiative for Chronic Obstructive Lung Disease, GOLD, which was diagnosed in the second people's Hospital in Kashi, Xinjiang, from March 2011 to June 2012. Diagnostic criteria COPD patients were selected from the same sex, family, age and COPD patients in the non Department of respiration at the second people's Hospital of Kashi in the same period. There was no chronic respiratory system and serious heart, liver, kidney disease as control. The investigation content referred to the epidemiological survey on the research topic of the disease COPD burden of the GOLD Committee. The questionnaire, taking into account the cultural background and humanistic quality of the Kashi region, made the language adjustment, including the basic data of demography, family lung disease history, smoking and passive smoking exposure, dust exposure, kitchen ventilation, fuel, oil smoker, nutritional status, dietary habits, and other 25 items and several sub items. The use of COPD Assessment Test (CAT) The quality of life of COPD patients was evaluated and its influencing factors were analyzed. All data were recorded and managed by Epi Data software. SPSS20.0 software was used for statistical analysis. A single factor unconditional Logistic regression analysis and multi factor unconditional Logistic regression analysis were used to determine the various risk factors and COPD in Kashi population. The correlation was expressed by odds ratio (OR) and 95% confidence interval (95% CI); all tests were double-tailed and a0.05 levels for statistical significance.
Results: a total of 256 patients were enrolled in this study, including 42 (16.4%), 214 Uygur (83.6%), and 128 cases in the case group and the control group. Each group was 21 (16.4%) and 107 (83.6%) of the Uygur nationality (83.6%). The average age was (63.3 + 10.1) years, and the case group was (62.7 +) years of age, and the sex and age of the group. The demographic characteristics were not statistically different (P0.05). The results of single factor analysis showed that: BMI, nutritional status, burning coal burning firewood index, heating mode in winter, dust contact, kitchen oil control smoke device, kitchen ventilation, smoking, passive smoking at home, passive smoking in the workplace, and family history of respiratory diseases in total 11 factors and COPD hair. Disease related (P0.05). The results of multifactor analysis showed: malnutrition (OR=6.4,95%CI:3.3-8.7), high burning coal burning wood index (OR=7.6,95%CI:3.7-9.3), smoking (OR=6.5,95%CI:1.9-22.2), family passive smoking (OR=2.2,95%CI:1.5-10.0) and workplace passive smoking (OR =8.2,95%CI:1.2-56.6). Dust exposure was the main risk of COPD Factors; kitchen ventilation was a protective factor for the onset of COPD. The results of multi factor linear regression model showed that coal burning coal burning index (beta =1.973,95%CI:0.126-3.820), dust exposure (beta =2.982,95%CI:0.956-5.009), and smoking (beta =1.557,95%CI:0.374-3.487) were positively correlated with CAT (P0.05), and kitchen ventilation (beta =-2.314,95%CI:-3.546-) -1.081), FEV1% (beta =-0.082,95%CI:-0.144--0.021) and FEV1/FVC (beta =-0.126,95%CI:-0.234--0.081) were negatively correlated with CAT (P0.05).
Conclusion: the index of burning coal and burning coal, dust contact is the environmental risk factor of COPD in Kashi area of Xinjiang, and it has an important influence on the quality of life of patients, especially the relationship between dust exposure and COPD disease, smoking and passive smoking are the risk factors of COPD in the people of Kashi, Xinjiang and the patients. The pulmonary function and the quality of life have an influence. The nutritional status is positively related to the risk of COPD disease, which is a risk factor for the pathogenesis of COPD; the kitchen ventilation is not only a protective factor for the pathogenesis of COPD, but the good ventilation in the kitchen can help to improve the quality of life of the patients.
【学位授予单位】：复旦大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R563.9
本文编号：2161347
[Abstract]:Objective: to analyze the related risk factors of chronic obstructive pulmonary disease (Chronic Obstructive Pulmonary Disease, COPD) in Kashi, Xinjiang, and the influencing factors of the quality of life of COPD patients; to provide scientific basis for the prevention and control of COPD in Kashi region of Xinjiang and the formulation of corresponding health policies and Strategies. The basic case control study was conducted using a unified questionnaire to investigate the case and control data. The cases were diagnosed by the Global Initiative for Chronic Obstructive Lung Disease, GOLD, which was diagnosed in the second people's Hospital in Kashi, Xinjiang, from March 2011 to June 2012. Diagnostic criteria COPD patients were selected from the same sex, family, age and COPD patients in the non Department of respiration at the second people's Hospital of Kashi in the same period. There was no chronic respiratory system and serious heart, liver, kidney disease as control. The investigation content referred to the epidemiological survey on the research topic of the disease COPD burden of the GOLD Committee. The questionnaire, taking into account the cultural background and humanistic quality of the Kashi region, made the language adjustment, including the basic data of demography, family lung disease history, smoking and passive smoking exposure, dust exposure, kitchen ventilation, fuel, oil smoker, nutritional status, dietary habits, and other 25 items and several sub items. The use of COPD Assessment Test (CAT) The quality of life of COPD patients was evaluated and its influencing factors were analyzed. All data were recorded and managed by Epi Data software. SPSS20.0 software was used for statistical analysis. A single factor unconditional Logistic regression analysis and multi factor unconditional Logistic regression analysis were used to determine the various risk factors and COPD in Kashi population. The correlation was expressed by odds ratio (OR) and 95% confidence interval (95% CI); all tests were double-tailed and a0.05 levels for statistical significance.
Results: a total of 256 patients were enrolled in this study, including 42 (16.4%), 214 Uygur (83.6%), and 128 cases in the case group and the control group. Each group was 21 (16.4%) and 107 (83.6%) of the Uygur nationality (83.6%). The average age was (63.3 + 10.1) years, and the case group was (62.7 +) years of age, and the sex and age of the group. The demographic characteristics were not statistically different (P0.05). The results of single factor analysis showed that: BMI, nutritional status, burning coal burning firewood index, heating mode in winter, dust contact, kitchen oil control smoke device, kitchen ventilation, smoking, passive smoking at home, passive smoking in the workplace, and family history of respiratory diseases in total 11 factors and COPD hair. Disease related (P0.05). The results of multifactor analysis showed: malnutrition (OR=6.4,95%CI:3.3-8.7), high burning coal burning wood index (OR=7.6,95%CI:3.7-9.3), smoking (OR=6.5,95%CI:1.9-22.2), family passive smoking (OR=2.2,95%CI:1.5-10.0) and workplace passive smoking (OR =8.2,95%CI:1.2-56.6). Dust exposure was the main risk of COPD Factors; kitchen ventilation was a protective factor for the onset of COPD. The results of multi factor linear regression model showed that coal burning coal burning index (beta =1.973,95%CI:0.126-3.820), dust exposure (beta =2.982,95%CI:0.956-5.009), and smoking (beta =1.557,95%CI:0.374-3.487) were positively correlated with CAT (P0.05), and kitchen ventilation (beta =-2.314,95%CI:-3.546-) -1.081), FEV1% (beta =-0.082,95%CI:-0.144--0.021) and FEV1/FVC (beta =-0.126,95%CI:-0.234--0.081) were negatively correlated with CAT (P0.05).
Conclusion: the index of burning coal and burning coal, dust contact is the environmental risk factor of COPD in Kashi area of Xinjiang, and it has an important influence on the quality of life of patients, especially the relationship between dust exposure and COPD disease, smoking and passive smoking are the risk factors of COPD in the people of Kashi, Xinjiang and the patients. The pulmonary function and the quality of life have an influence. The nutritional status is positively related to the risk of COPD disease, which is a risk factor for the pathogenesis of COPD; the kitchen ventilation is not only a protective factor for the pathogenesis of COPD, but the good ventilation in the kitchen can help to improve the quality of life of the patients.
【学位授予单位】：复旦大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R563.9
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