吸烟者慢性阻塞性肺疾病外环境因素的病例对照研究  

Case-control Study on the Effects of Environmental Factors on COPD in Smokers

作　　者：张啸飞[1] 程显声[1] 李景周[2] 华毅 徐希胜[2] 李清[1] 李智[1] 李亚辉[1] 

机构地区：[1]中国医学科学院中国协和医科大学,阜外心血管病医院100037 [2]北京市房山区第一医院

出　　处：《中国慢性病预防与控制》2000年第1期20-22,共3页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：国家"九.五"攻关课题!(96-906-02-03)

摘　　要：目的：提供除吸烟以外的外环境因素与吸烟发生慢性阻塞性肺疾病（ＣＯＰＤ）关系的信息。方法：在北京房山区２３个自然村筛查出１５４例吸烟无慢性呼吸道疾病症状的ＣＯＰＤ患者（ＦＥＶ１／ＦＶＣ＜７０％），在同年龄（±３岁）、同性别、同居住地吸烟的正常人群中（无慢性呼吸道疾病症状且ＦＥＶ１／ＦＶＣ≥７５％），按１∶１配对作为对照。其中男性１３７对，女性１７对。问卷包括个人一般情况、居室环境、职业暴露史、吸烟史、饮酒史、过敏史、个人史、家族史。肺功能测定，包括用力肺活量（ＦＶＣ），第一秒用力肺活量（ＦＥＶ１）及ＦＥＶ１／ＦＶＣ等。结果：病例组与对照组年龄、受教育程度、吸烟量无显著差异。单因素分析：冬季热炉取暖方式（ＯＲ＝１．７５）、厨房没有安装抽油烟机（ＯＲ＝２．０３）及居住土坯房屋类型（ＯＲ＝１．８２）等居室环境与ＣＯＰＤ发生有关联（Ｐ＜０．０５）；接触谷尘（ＯＲ＝１．６３）、化学品（ＯＲ＝１１．７７）等职业暴露；吸烟深吸（ＯＲ＝１．６８）、有无过滤嘴（ＯＲ＝２．５５）、家族慢性支气管炎史（ＯＲ＝１．７４）等与ＣＯＰＤ发生有关联，统计学上有显著性意义。多因素Ｌｏｇｉｓｔｉｃ分析结果表明，接触化学品（ＯＲ＝３．２７）。Objective:To provide some information about effects of environmental factors except smoking on developing COPD.Methods:A case control pair was made.154 patients with COPD (FEV1/FVC<70%) were enrolled in the case group who se smoking index (average cigarettes per day multiply smoking years)was ≥300. 154 smokers without COPD(FEV1/FVC≥75%)and respiratory symptoms were selected as the control group matched by age(±3 years),sex and residence.The questionnaire,lung function test were conducted.The items of questionnaire included individual information,condition of living house,occupational exposure,habit of smoking,history of allergy and family history.The lung function test included FVC,FEV1,FEV1/FVC. Results:There was no significantly difference of age,education and smoking index between two groups.Single factor analysis showed that condition of living house such as stove heating in winter( OR =1 75),without growing oil machine in kitchen( OR =2 03) and shabby living house( OR =1 82)were associated with COPD( P <0 05).Occupational exposure such as grain dust( OR =1 63),chemicals( OR =11 77)were also associated with COPD.The deep breath smoking( OR =1 68),cigarette without filter tip( OR =2 55),and famliy history of chronic bronchitis( OR =1 74) were related to COPD with a statistical significance.Using Logistic regression method,the findings indicated that there were also association between COPD and the factors of contacting chemicals( OR =3 27),deep breath smoking( OR =1 29),and without drawing oil machine in kitchen( OR =2 15).Conclusion:The environmental factors of chemical fog,grain dust,condition of kitchen in living house and deep breath smoking are critical risk factors affecting COPD development.

关 键 词：慢性 吸烟 阻塞性肺疾病 环境因素 

分 类 号：R563.02[医药卫生—呼吸系统]