【摘要】：目的了解寧夏地區(qū)慢性阻塞性肺疾�。–OPD）的患病率，了解COPD的診治狀況，分析COPD相關危險因素，為COPD的人群防治提供科學依據(jù)。 方法參考BOLD問卷制定流行病學調(diào)查表，采用多級分層整群隨機抽樣的方法，在寧夏地區(qū)選取40周歲以上人群進行調(diào)查，（1）所有被調(diào)查人員填寫統(tǒng)一的調(diào)查問卷表。（2）所有被調(diào)查人員進行肺功能檢查，參照中華醫(yī)學會呼吸病學分會慢性阻塞性肺疾病學組制定的COPD診治指南(2007年修訂版)，以吸入支氣管舒張劑后第一秒用力呼氣容積/用力肺活量（FEV1/FVC）70%作為診斷COPD的診斷金標準，結合呼吸道病史做出診斷。（3）對FEV1/FVC 70%的人員進行體格檢查，完成心電圖、X胸片檢查，做出鑒別診斷，最終確定診斷。 結果（1）共調(diào)查4626人，資料完整且肺功能檢查質(zhì)控合格者4055例，其中男1869例，女2186例，平均年齡55.5±12.1歲，符合COPD診斷者360例，COPD總患病率8.87%。（2）男性COPD患病率為13.01%，女性為5.35%，男性COPD患病率高于女性，差異有統(tǒng)計學意義（x~2=72.87，P=0.000）。（3）漢族COPD患病率為9.35%，回族為7.98%，漢族COPD患病率高于回族，差異有統(tǒng)計學意義（x~2=7.48，P=0.024）。（4）以十歲為一年齡段分層比較，40~49歲、50~59歲、60~69歲和70歲以上人群COPD患病率分別為4.08%、9.13%、11.86%和13.59%。隨著年齡的增大COPD患病率增高，差異有統(tǒng)計學意義（x~2=68.37，P0.05）。（5）農(nóng)村COPD患病率為9.78%，城鎮(zhèn)為7.97%，農(nóng)村COPD患病率高于城鎮(zhèn)，差異有統(tǒng)計學意義（x~2=4.10，P0.05）。（6）吸煙者COPD患病率為15.42%，不吸煙者6.23%，吸煙者COPD患病率高于不吸煙者，差異有統(tǒng)計學意義（x~2=94.65，P=0.000）。以吸煙指數(shù)為10分層，吸煙指數(shù)越大患病率越高，，差異有統(tǒng)計學意義（x~2=125.38，P=0.000）。（7）寧夏地區(qū)40歲以上人群COPD診斷率為23.61%，城鎮(zhèn)診斷率（27.95%）高于農(nóng)村（20.10%），COPD治療率23.33%，肺功能檢查I級~IV級所占的比例分別為25.28%、64.17%、10.28%、2.78%。（8）應用多因素Logistic回歸分析，影響寧夏地區(qū)COPD患病的主要危險因素有：男性、高齡、吸煙、兒童期呼吸道疾病、呼吸道疾病家族史、低體重指數(shù)和職業(yè)粉塵暴露大于一年。 結論寧夏地區(qū)40歲以上人群COPD的總體患病率為8.87%，男性COPD患病率高于女性，漢族高于回族，農(nóng)村高于城鎮(zhèn)，吸煙者高于不吸煙者，隨著年齡增長COPD患病率逐漸上升。COPD診斷率和治療率均較低。男性、高齡、吸煙、兒童期呼吸道疾病、呼吸道疾病家族史、低體重指數(shù)和職業(yè)粉塵暴露大于一年是寧夏地區(qū)COPD的危險因素。
[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 鹵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.
【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R563.9

【參考文獻】

相關期刊論文 前10條

1 史清明,張宜文,倪進發(fā);慢性阻塞性肺病危險因素的病例對照研究[J];安徽預防醫(yī)學雜志;2002年04期

2 王臻,王辰;可吸入顆粒物對呼吸系統(tǒng)危害的研究進展[J];國外醫(yī)學.呼吸系統(tǒng)分冊;2004年04期

3 ;COPD診治指南(2007年修訂版)[J];繼續(xù)醫(yī)學教育;2007年02期

4 蔡柏薔;;科學認識、重視防治、勇于探索——評析國內(nèi)外慢性阻塞性肺疾病診斷和治療新指南[J];內(nèi)科理論與實踐;2007年05期

5 巽浩一郎 ,萬獻堯 ,畢麗巖;日本COPD的流行病學及危險因素[J];日本醫(yī)學介紹;2003年10期

6 徐衛(wèi)國,羅勇,姚迪,沈錚;慢性阻塞性肺病急性期營養(yǎng)狀態(tài)對免疫的影響[J];上海第二醫(yī)科大學學報;1999年02期

7 湯泰秦;從慢性阻塞性肺疾病的病因談其社區(qū)預防[J];實用醫(yī)學雜志;2002年07期

8 蔣汝剛;羅德生;黃翠萍;李偉明;;農(nóng)村居民慢性阻塞性肺疾病危險因素分析[J];中國公共衛(wèi)生;2008年03期

9 陳婉貞,葉秀文,劉春濤;亞太地區(qū)慢性呼吸系統(tǒng)疾病的負擔——現(xiàn)在與未來[J];中國呼吸與危重監(jiān)護雜志;2002年01期

10 周玉民,冉丕鑫;慢性阻塞性肺疾病的流行病學[J];中國呼吸與危重監(jiān)護雜志;2004年02期

本文編號：2182373