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。
Objective To explore influencing factors related to acute exacerbation of chronic obstructive pulmonary disease （COPD） patients in Chinese re＇ban communities. Methods A cross-sectional survey was carried out in Beijing, Shanghai, Chengdu and Guangzhou. Total 678 subjects with COPD were recruited continuously into this study. Subjects were face-to-face interviewed with a structured questionnaire and their medical records were also checked. All data were entered into Epi data twice, and analyzed by SAS 9. 2. Results In recent one year, the frequency of exacerbation for COPD was （ 1.5± 1.9） , and more than one third （35.4%） did not suffer from any acute exacerbation of COPD （AECOPD） , while the same proportion （35.4%） had more than two exacerbations. AECOPD patients was older, had longer courses, and higher proportions of BMI abnormity, family history of COPD, fnrmer smokers, no regular physical activities, and ad- vanced severity of COPD than patients without any acute exacerbation. Former smoker（OR ： 2.53, 95% CI： 1.32-4. 87 ） , no regular physical activities（ OR = 1.96, 95% CI： 1.21-3. 17 ） and advanced severity （ stage Ⅲ （ OR = 2.81 , 95% CI： 1.38-5.71 ） and stage Ⅳ （ OR = 3.29, 95% CI： 1.20-9. 01 ） ） of COPD were possible risk factors of frequently AECOPD in last year. Conclusions Acute exacerbation of COPD was prevalent for COPD patients from urban communities in big Chi- nese cities. More attentions should be paid to COPD patients with former smoker, no regular physical exercise and advanced severity.
出处
《中华疾病控制杂志》
CAS
CSCD
北大核心
2017年第2期110-113,122,共5页
Chinese Journal of Disease Control & Prevention
基金
上海市卫生计生委项目(201540415)
关键词
肺疾病
慢性阻塞性
危险因素
流行病学研究
Pulmonary disease, chronic obstructive
Risk factors
Epidemiologic studies
