新疆边远地区少数民族COPD合并PH流行病学危险因素分析  

Analysis on epidemiological risk factors of COPD combined with PH among ethnic minorities in remote areas of Xinjiang

作　　者：周海霞 张峰 ZHOU Hai-xia;ZHANG Feng(Department of Respiratory,Xinjiang Command General Hospital,Urumqi Xinjiang,830000,China)

机构地区：[1]新疆军区总医院呼吸科,新疆乌鲁木齐830000

出　　处：《职业与健康》2020年第24期3384-3387,3392,共5页Occupation and Health

基　　金：新疆维吾尔自治区科技成果转化项目(201554145)。

摘　　要：目的分析新疆边远地区少数民族慢性阻塞性肺疾病(COPD)合并肺动脉高压(PH)的危险因素,为预防和治疗COPD合并PH提供参考依据。方法回顾分析2009年4—10月在新疆边远地区3所三级甲等医院呼吸内科住院治疗COPD合并PH的117例少数民族患者临床特征,采用COX回归分析危险因素。结果调查对象117例,年龄5081(65.15±6.67)岁,病程512(6.01±2.17)年,其中38例患者出现右心衰竭,占32.48%;26例患者出现肺栓塞,占22.22%;23例患者出现脑血管病,占19.66%;18例患者出现肺癌,占15.38%;12例患者出现其他疾病,占10.26%。不同高血压史、冠心病史、服药依从性、饮食习惯、体质指数(BMI)、情绪波动、臀围与COPD合并PH患者严重程度比较,差异均有统计学意义(χ^(2)=8.916、7.565、7.325、8.074、6.254、6.690、7.598,均P<0.05)。多因素COX回归分析显示,高血压史(HR=8.268,95%CI=2.47710.354)、冠心病史(HR=1.003,95%CI=1.0011.217)、BMI(HR=4.369,95%CI=1.5692.172)、服药依从性(HR=0.371,95%CI=0.1820.756)、饮食习惯(HR=2.252,95%CI=1.9567.417)、情绪波动(HR=1.787,95%CI=1.8704.102)、臀围(HR=1.055,95%CI=1.1113.501)与COPD合并PH的发生发展密切相关(均P<0.05)。结论高血压史、冠心病史、BMI、服药依从性、饮食习惯、情绪波动及臀围是COPD合并PH的危险因素,应针对以上危险因素加强COPD合并PH的预防和干预。Objective To explore the risk factors of chronic obstructive pulmonary disease(COPD)combined with pulmonary hypertension(PH)in minority nationalities in remote areas of Xinjiang,provide reliable basis for the prevention and treatment of COPD combined with PH.Methods The clinical characteristics of 117 minority patients with COPD combined with PH,who were hospitalized in respiratory medicine department of three grade-A tertiary hospitals remote areas of Xinjiang from April to October2019,were analyzed retrospectively,and the risk factors were explored by COX regression.Results There were 117 patients in the study,withe the age of 50-81(65.15±6.67)years old and disease course of 5-12(6.01±2.17)years.38 patients had right heart failure(32.48%),26 had pulmonary embolism(22.22%),23 had cerebrovascular disease(19.66%),18 had lung cancer(15.38%),and12 had other diseases(10.26%).There were statistically significant differences in severity among patients in different history of hypertension,history of coronary heart disease,medication compliance,dietary habits,body mass index(BMI),mood fluctuation,and hip circumference(χ^(2)=8.916,7.565,7.325,8.074,6.254,6.690,7.598,all P<0.05).Multivariate COX regression analysis showed that history of hypertension(HR=8.268,95%CI=2.477-10.354),history of coronary heart disease(HR=1.003,95%CI=1.001-1.217),BMI(HR=4.369,95%CI=1.569-2.172),medication compliance(HR=0.371,95%CI=0.182-0.756),dietary habits(HR=2.252,95%CI=1.956-7.417),mood fluctuation(HR=1.787,95%CI=1.870-4.102),and hip circumference(HR=1.055,95%CI=1.111-3.501)were closely related to the occurrence and development of COPD combined with PH(all P<0.05).Conclusion History of hypertension,history of coronary heart disease,BMI,medication adherence,dietary habits,mood fluctuation,and hip circumference are risk factors of COPD combined with PH.It is necessary to strengthen prevention and intervention of COPD combined with PH according to the above risk factors.

关 键 词：慢性阻塞性肺疾病 肺动脉高压 少数民族 危险因素 

分 类 号：R181.3[医药卫生—流行病学]