宁夏慢性阻塞性肺疾病流行病学调查分析

发布时间：2018-08-14 09:08

【摘要】：目的了解宁夏地区慢性阻塞性肺疾病（COPD）的患病率，了解COPD的诊治状况，分析COPD相关危险因素，为COPD的人群防治提供科学依据。方法参考BOLD问卷制定流行病学调查表，采用多级分层整群随机抽样的方法，在宁夏地区选取40周岁以上人群进行调查，（1）所有被调查人员填写统一的调查问卷表。（2）所有被调查人员进行肺功能检查，参照中华医学会呼吸病学分会慢性阻塞性肺疾病学组制定的COPD诊治指南(2007年修订版)，以吸入支气管舒张剂后第一秒用力呼气容积/用力肺活量（FEV1/FVC）70%作为诊断COPD的诊断金标准，结合呼吸道病史做出诊断。（3）对FEV1/FVC 70%的人员进行体格检查，完成心电图、X胸片检查，做出鉴别诊断，最终确定诊断。结果（1）共调查4626人，资料完整且肺功能检查质控合格者4055例，其中男1869例，女2186例，平均年龄55.5±12.1岁，符合COPD诊断者360例，COPD总患病率8.87%。（2）男性COPD患病率为13.01%，女性为5.35%，男性COPD患病率高于女性，差异有统计学意义（x~2=72.87，P=0.000）。（3）汉族COPD患病率为9.35%，回族为7.98%，汉族COPD患病率高于回族，差异有统计学意义（x~2=7.48，P=0.024）。（4）以十岁为一年龄段分层比较，40~49岁、50~59岁、60~69岁和70岁以上人群COPD患病率分别为4.08%、9.13%、11.86%和13.59%。随着年龄的增大COPD患病率增高，差异有统计学意义（x~2=68.37，P0.05）。（5）农村COPD患病率为9.78%，城镇为7.97%，农村COPD患病率高于城镇，差异有统计学意义（x~2=4.10，P0.05）。（6）吸烟者COPD患病率为15.42%，不吸烟者6.23%，吸烟者COPD患病率高于不吸烟者，差异有统计学意义（x~2=94.65，P=0.000）。以吸烟指数为10分层，吸烟指数越大患病率越高，，差异有统计学意义（x~2=125.38，P=0.000）。（7）宁夏地区40岁以上人群COPD诊断率为23.61%，城镇诊断率（27.95%）高于农村（20.10%），COPD治疗率23.33%，肺功能检查I级~IV级所占的比例分别为25.28%、64.17%、10.28%、2.78%。（8）应用多因素Logistic回归分析，影响宁夏地区COPD患病的主要危险因素有：男性、高龄、吸烟、儿童期呼吸道疾病、呼吸道疾病家族史、低体重指数和职业粉尘暴露大于一年。结论宁夏地区40岁以上人群COPD的总体患病率为8.87%，男性COPD患病率高于女性，汉族高于回族，农村高于城镇，吸烟者高于不吸烟者，随着年龄增长COPD患病率逐渐上升。COPD诊断率和治疗率均较低。男性、高龄、吸烟、儿童期呼吸道疾病、呼吸道疾病家族史、低体重指数和职业粉尘暴露大于一年是宁夏地区COPD的危险因素。
[Abstract]:Objective to investigate the prevalence of chronic obstructive pulmonary disease (COPD) in Ningxia region, to understand the diagnosis and treatment of COPD, to analyze the risk factors related to COPD, and to provide scientific basis for the prevention and treatment of COPD. Methods Epidemiology questionnaire was made with reference to BOLD questionnaire, and multilevel stratified cluster random sampling was used. In Ningxia, people over 40 years old were selected for the investigation. (1) all the respondents filled out a unified questionnaire form. (2) all the respondents performed pulmonary function tests. According to the guidelines for the diagnosis and treatment of chronic obstructive pulmonary disease (COPD) (revised edition, 2007), the forced expiratory volume / forced vital capacity (FEV1/FVC) of the first second after inhaling bronchodiastolic agent was taken as the diagnostic gold standard for the diagnosis of COPD. Combined with respiratory history to make diagnosis. (3) 70% of FEV1/FVC personnel were examined by physical examination, electrocardiogram X-ray examination was completed, differential diagnosis was made, and final diagnosis was confirmed. Results (1) A total of 4626 patients were investigated, 4055 of them were qualified for quality control of lung function examination, 1869 males and 2186 females, with an average age of 55.5 卤12.1 years. (2) the prevalence rate of COPD in males was 13.01 and 5.35 in females, and the prevalence of COPD in males was higher than that in females. The difference was statistically significant (xan2zhuan72.87 P0.000). (3) the prevalence rate of COPD in Han nationality was 9.35, that in Hui nationality was 7.98. The prevalence rate of COPD in Han nationality was higher than that in Hui nationality, and the prevalence rate of COPD in Han nationality was higher than that in Hui nationality. The difference was statistically significant (XY2C7.48). (4). The prevalence of COPD was 4.08% and 13.59% in the population aged 60 to 69 years old and over 70 years old, respectively, and 11.86% and 13.59% in the age group of 10 years old and 50 years old and 59 years old respectively. With the increase of age, the prevalence rate of COPD increased, and the difference was statistically significant (XX2, 68.37, P0.05). (5). The prevalence rate of COPD was 9.78 in rural areas and 7.97 in urban areas. The prevalence of COPD in rural areas was higher than that in urban areas. The prevalence rate of COPD in smokers was 15.42 and 6.233.The prevalence of COPD in smokers was higher than that in non-smokers (XX2 + 94.65 P0. 000). With a smoking index of 10 layers, the higher the smoking index, the higher the prevalence. The diagnostic rate of COPD in people over 40 years old in Ningxia was 23.61, and the diagnostic rate in town (27.95%) was higher than that in rural area (20.10%). The proportion of grade I and IV in pulmonary function examination was 25.2864.1710.282.78. (8) multivariate Logistic regression analysis was used. The main risk factors affecting COPD in Ningxia were: male, old age, smoking, childhood respiratory disease, family history of respiratory disease, low body mass index and occupational dust exposure more than one year. Conclusion the overall prevalence of COPD in the population over 40 years old in Ningxia is 8.87. The prevalence of COPD in male is higher than that in female, in Han nationality is higher than that in Hui nationality, in rural area is higher than that in urban area, and in smokers is higher than that in non-smokers. The diagnostic rate and treatment rate of COPD increased with age. Male, old age, smoking, childhood respiratory disease, family history of respiratory disease, low body mass index and occupational dust exposure were risk factors of COPD in Ningxia.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R563.9

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