社区综合干预对北京市郊区吸烟、慢性支气管炎和哮喘流行的影响  

Effects of Comprehensive Interventions in Community on Smoking, Chronic Bronchitis, and Asthma in Rural Areas of Beijing

作　　者：谢高强 程显声[2] 徐希胜 谢宝元 李瑶 武阳丰 郝凤霞 秦富军 

机构地区：[1]Department of Epidemiology, Fuwai Hospital, CAMS and PUMC,Beijing [2]中国医学科学院中国协和医科大学阜外心血管病医院肺血管病诊治中心,北京100037 [3]Department of Internal Medicine, Chinese Traditional Medicine Hospital in Fangshan District,Beijing [4]Department of Respiration, First Hospital in Fangshan District,Beijing [5]Department of Internal Medicine, First Hospital in Fangshan District,Beijing

出　　处：《中国医学科学院学报》2005年第1期92-98,共7页Acta Academiae Medicinae Sinicae

基　　金：国家九五攻关项目(96-906-02-03)~~

摘　　要：目的研究社区综合干预对北京市郊区人群吸烟、慢性支气管炎和哮喘流行情况的影响。方法1992年,将北京市房山区23个自然村整群随机分为13个干预村和10个对照村,对干预村进行以戒烟、改善居住环境为主的社区人群综合干预,对照村未施加干预。2000年4月,对干预区和对照区34436名15岁以上人群进行吸烟、慢性支气管炎和哮喘流行情况普查。同期,对1658名慢性阻塞性肺疾病(COPD)高危人群进行卫生知识水平、居住环境和吸烟状况的基线调查和复查。结果干预区男女高危人群卫生知识水平得分改善幅度和居住环境好转率显著大于对照区(P<0.001)。干预区全人群中男性吸烟率、现吸烟率下降幅度显著大于对照区(0.4%vs-0.8%,P<0.001;2.4%vs1.3%,P<0.001),女性差异无显著性(P>0.05)。无论男女,干预区15～24岁人群1993～2000年累积新吸烟率显著低于对照区(男:18.9%vs23.7%,P=0.005;女:0%vs0.7%,P=0.005)。干预区吸烟者日吸烟支数低于对照区男:(14.8±7.0)支/dvs(17.2±8.2)支/d,P<0.001;女:(12.8±6.9)支/dvs(13.4±7.2)支/d,P=0.088。由于人群老龄化,慢性支气管炎患病率呈上升趋势,干预村上升幅度低于对照村(男:0.9%vs1.3%,P=0.012;女:0.1%vs0.3%,P=0.003)。控制年龄因素后,干预村慢性支气管炎1993～2000年累积发病率低于对?Objective To study the effects of comprehensive interventions in community on smok-ing, chronic bronchitis, and asthma in rural areas of Beijing. Methods Twenty-three villages in rural areas of Beijing were randomly divided into interventional(13 villages)and control villages(10 villages)in 1992. Comprehensive interventions including education of former-smokers and improvement of living environment were carried out in the interventional villages, and none was done in the control villages. In April 2000,surveys on smoking, chronic bronchitis, and asthma were carried out among 34 436 partici-pants aged 15 or more in the interventional and control villages. During the same period, knowledge on prevention from chronic obstructive pulmonary diseases(COPD), living environments, and smoking were assessed among 1 658 high-risk individuals of COPD at baseline and following-up period. ResultsThe scores of knowledge and improvement on living environments in the interventional villages were significantly higher than those in control villages(P < 0.001). The decrease rate of smoking and current smoking rate in the interventional villages were significantly higher than in the control villages(0.4% vs -0.8%, P < 0.001;2.4% vs 1.3%, P < 0.001)in men, while not different in women(P > 0.05). Among never smokers at baseline, the accumulated incidence of smoking among people aged 15 to 24 from 1993 to 2000 was significantly lower in the interventional villages than in the control villages in men(18.9% vs 23.7%, P = 0.005)and in women(0% vs 0.7%, P = 0.005). Daily cigarettes smoked by smokers in the interventional villages were less than in control villages in both men(14.8 ± 7.0 vs 17.2 ± 8.2 cigs daily, P < 0.001)and women(12.8 ± 6.9 vs 13.4 ± 7.2 cigs daily, P = 0.088). The increase of prevalence of chronic bronchitis in the interventional villages was less than in the control villages(men:0.9% vs 1.3%, P = 0.012; women:0.1% vs 0.3%, P = 0.003). After the age factor is adjusted, odds ratio(OR)for accumulated incidence of chr

关 键 词：社区干预 吸烟 慢性支气管炎 哮喘 

分 类 号：R163[医药卫生—公共卫生与预防医学] R562.21