北京市社区居民第一秒用力呼气容积下降相关因素分析  

Analysis of factors associated with decline of FEV1 among community population in urban area of Beijing

作　　者：郭翠艳[1] 赵燕妮[1] 程渊[1] 王玺[1] 李楠[1] 刘俊青 康卉 夏国光[3] 胡萍[3] 张平骥[3] 马靖[1] 刘莹[1] 张成[1] 宿利[1] 王广发[1] 

机构地区：[1]北京大学第一医院呼吸和危重症医学科,100034 [2]北京市西城区什刹海社区卫生服务中心 [3]北京积水潭医院呼吸与危重症学科

出　　处：《中华结核和呼吸杂志》2015年第5期361-365,共5页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：首都医学发展科研基金（2007-1004）;国家自然科学基金（81370106）;北京大学临床研究项目（PUCRP201303）

摘　　要：目的 探索北京市城区居民第一秒用力呼气容积（FEV1）下降速度的危险因素.方法 在北京市中心3个社区招募40岁以上志愿者共452例,平均年龄（58.8±8.6）岁,其中男131例（29％）,女321例（71％）.通过问卷调查获得一般情况、既往病史、吸烟史、生活环境情况等.并对受试者先后行2次肺功能检查,测定FEV1及6秒用力呼气容积（FEV6）,对FEV1/FEV6＜ 70％的受试者行支气管舒张试验.第一次调查约2年后,随诊复查上述问卷及肺功能检查.结果 完成2次调查及肺功能的受试者总FEV1年下降量平均值为（43 ± 114） ml（95％ CI：33 ～54 ml）.吸烟者与不吸烟相比,FEV1年下降量分别为（64±125）和（36±109） ml,而戒烟对FEV1下降速度无明显影响.肺功能检查发现慢阻肺及气道高反应性者,其FEV1下降速度快于肺功能正常人群,但差异无统计学意义.另外,慢性咳嗽病史、糖尿病、冠状动脉性心脏病、高血压等病史的人群FEV1下降速度均高于无上述病史者,但差异无统计学意义.在FEV1快速下降组（△FEV1 ≥30 ml/y）与非快速下降组（△FEV1＜30 ml/y）间,进行二元logistic回归分析上述因素后发现,吸烟为FEV1下降加速的独立危险因素.结论 北京市中心部分社区居民的FEV1在2年多时间内平均下降速度为（43±114） ml/y,吸烟是FEV1快速下降的独立危险因素.Objective To investigate risk factors correlated to the decline of FEV1 among community population in the urban area of Beijing.Method Subjects no younger than 40 years old were recruited from three communities in the urban area of Beijing.All of them were asked to fill in a questionnaire in regard to general health conditions,past medical history,medication usage,smoking history,etc.FEV1 and FEV6 were measured by Vitalograph COPD-6 spirometer using the standard protocol.Two years after the first visit,questionnaire survey and spirometry were repeated.Result Four hundred and fifty two subjects fulfilled the inclusion criteria and finished the 2nd visit,with an average age of （58.8 ±8.6） years,29% male and 71% female.The mean decline rate of FEV1 in the cohort was （43 ± 114） ml per year.There was no significant difference of mean FEV1 decline between different gender and age groups.A mean decline of FEV1 by （64 ± 125） ml per year was observed in smokers （including former smokers and current smokers） whereas the decline rate in non-smokers was （36 ± 109） ml per year（P =0.030）.There was no significant statistical difference among current smokers,former smokers,passive smokers and subjects who never smoke.A higher decline rate of FEV1 was observed in subjects with a history of COPD or airway hyperreactivity,chronic cough,diabetes,hypertension and coronary heart disease.The difference,however,was not statistically significant.Binary logistic regression was used to screen risk factors affected the FEV1 decline rate between rapid decline （△FEV1 ≥ 30 ml/y） and non-rapid decline （△FEV1 〈30 ml/y）,and found smoking was an independent risk factor of FEV1 decline rate.Conclusion The mean rate of FEV1 decline in 2.6 years in the surveyed community population in the urban area of Beijing was （43 ± 114） ml per year;Smoking is an independent risk factor of FEV1 decline.

关 键 词：第一秒用力呼气容积下降 吸烟 肺疾病 慢性阻塞性 

分 类 号：R563.9[医药卫生—呼吸系统]