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(stageⅢ(OR=2.81,95%CI:1.38-5.71)and stageⅣ(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.
作者
肖甜
陈晓英
王娜
赵琦
付朝伟
徐飚
XIAO Tian;CHEN Xiao-ying;WANG Na;ZHAO Qi;FU Chao-wei;XU Biao(Department of Epidemiology,School of PublicHealth,Key Laboratory of Public Health and Safety of Ministry of Education,Pudong Institute of Preventive Medicine,Fu-dan University,Shanghai 200032,China)
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
