慢性支气管炎患者慢性阻塞性肺疾病发病影响因素的研究  

Risk factors of chronic obstructive pulmonary disease in patients with chronic bronchitis

作　　者：谢高强[1] 程显声[2] 徐希胜[3] 张珍祥[4] 刘国华[5] 武阳丰[2] 谢宝元[3] 徐永健[4] 李胜歧[6] 李清[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研究所阜外心血管病医院流行病研究室,北京100037 [2]中国医学科学院中国协和医科大学阜外心血管病研究所阜外心血管病医院心脏肺循环研究室,北京100037 [3]北京市房山区第一医院心肺疾病研究中心 [4]同济医科大学附属同济医院呼吸科 [5]中国医科大学第二临床学院信息科 [6]中国医科大学第二临床学院内科

出　　处：《中华医学杂志》2001年第22期1356-1359,共4页National Medical Journal of China

基　　金："九五"国家攻关课题基金资助项目 ( 96 90 6 0 2 0 3)

摘　　要：目的　研究慢性支气管炎患者慢性阻塞性肺疾病 (COPD)发病的影响因素。方法　 1992年对≥ 15岁的 6 72 5 1名农民普查发现 1999例未发生COPD的慢性支气管炎患者 ,收集吸烟、COPD家族史、炉灶情况、粉尘接触、肺功能等基线资料。整群随机分为干预区和对照区 ,对干预区实施戒烟宣传等干预措施。 2 0 0 0年采用分层随机抽样方法抽取 1114例进行复查。结果　应答且资料完整者 86 9例 (占 1114例的 78 0 %)。吸烟、基线COPD家族史阳性使第 1秒用力呼气量 (FEV1)和 /或第 1秒用力呼气量百分比 (FEV1/FVC)随年龄下降速度加快 ,戒烟者与不吸烟者下降速度无显著差异。COPD 8年累积发病与基线年龄、吸烟、COPD家族史阳性呈独立的正相关 ,而与基线FEV1和FEV1/FVC呈独立的负相关。戒烟与不吸烟者发病危险差异无显著意义。结论　衰老、吸烟、COPD家族史、肺功能低下是慢性支气管炎患者COPD发病独立的危险因素 ,性别不是独立的危险因素 ,戒烟可使吸烟者发病危险降低至近似于不吸烟者的水平。Objective To explore the risk factors of chronic obstructive pulmonary disease (COPD) in patients with chronic bronchitis in following-up 8 years. Methods The baseline survey of the study was carried out on 1 999 patients with chronic bronchitis screened out from 67 251 (15 years or more) rural people in 1992. In 2000, 1 114 patients were reexamined by simple random sampling method. Results 869 (78.0% of 1 114 ) with complete data entered analysis of this study. Smoking, and family history of COPD were associated significantly positively with the decrement per capita yearly of FEV 1 (forced expiratory volume in the first second) and/or FEV 1/FVC (forced vital capacity) ratio. Ex-smoking decreased the decrement of lung function in smokers. The accumulative incidence of COPD was associated positively with smoking and family history of COPD and negatively with baseline FEV 1 and FEV 1/FVC. The relative risk of COPD was not significantly different between non-smokers and ex-smokers. Conclusion For Chinese rural patients with chronic bronchitis, aging, smoking, family history of COPD, lower pulmonary function are independent risk factors of COPD while sex is not one. Ex-smoking can almost decrease the relative risk of COPD to the approximative risk level of non-smoking.

关 键 词：慢性支气管炎 阻塞性肺疾病 危险因素 

分 类 号：R562.21[医药卫生—呼吸系统] R563.9[医药卫生—内科学]