中国城市社区COPD患者急性加重的相关因素调查

发布时间：2018-08-10 07:33

【摘要】：目的探索影响中国大城市社区慢性阻塞性肺部疾病(chronic obstructive pulmonary disease,COPD)患者急性加重的相关因素。方法采用横断面研究设计,在北京市、上海市、成都市和广州市连续募集了678名确诊的成人COPD患者。采用统一设计的调查表,由经过统一培训的调查员面对面访问研究对象,同时查阅患者病历卡。在Epi Data 3.1中文版建立数据库,统计分析在SAS 9.2中完成。结果在调查前的一年内,研究对象平均急性发作(1.5±1.9)次,超过三分之一(35.4%)的研究对象在近一年内没有发生急性加重情况,相同比例的患者(35.4%)在近一年内COPD急性加重2次及以上。近一年内发生COPD急性加重患者与未发生急性加重患者相比,前者平均年龄更大,病程更长,体质指数(body mass index,BMI)异常、有吸烟史、未规律体育锻炼、有家族史和重度及以上患者比例更高。多变量分析显示曾经吸烟、未规律体育锻炼,重度与极重度病情均是近一年内发生频发性COPD急性加重的危险因素,OR(95%CI)值分别为2.53(1.32~4.87)、1.96(1.21~3.17)、2.81(1.38~5.71)、3.29(1.20~9.01)。结论大城市社区COPD患者发生急性加重比较常见,需重点关注曾经吸烟、未规律体育锻炼和严重程度高的患者。
[Abstract]:Objective to explore the related factors of acute exacerbation of chronic obstructive pulmonary disease (chronic obstructive pulmonary) in Chinese metropolitan community. Methods 678 adult COPD patients were recruited in Beijing, Shanghai, Chengdu and Guangzhou by cross-sectional study. The unified questionnaire was used to interview the subjects face-to-face by the trained investigators and to consult the patient's medical record card at the same time. The database was established in the Chinese version of Epi Data 3.1, and the statistical analysis was completed in SAS 9.2. Results in the year before investigation, the average acute attack was (1. 5 卤1. 9) times, more than 1/3 (35. 4%) subjects had no acute exacerbation in nearly one year, and the same proportion of patients (35. 4%) had two or more acute exacerbations of COPD in the past year. In the past one year, the average age, duration, body mass index (body mass) and body mass index (body mass) of the patients with acute exacerbation of COPD were higher than those of the patients without acute aggravation, and had a history of smoking and irregular physical exercise. The proportion of patients with family history and severity and above was higher. Multivariate analysis showed that smoking, irregular physical exercise, severe and extremely severe illness were the risk factors of frequent acute exacerbation of COPD in the past one year. The OR (95%CI) values were 2.53 (1.324.87) / 1.96 (1.21 / 3.17) and 2.81 (1.385.71) / 3.29 (1.209.01), respectively. Conclusion Acute aggravation is common in COPD patients in the community of big cities. It is necessary to focus on the patients who have smoked, irregular physical exercise and high severity.
【作者单位】：复旦大学公共卫生学院流行病学教研室公共卫生安全教育部重点实验室复旦大学浦东预防研究院;
【基金】：上海市卫生计生委项目(201540415)
【分类号】：R563.9

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