非吸烟人群慢性阻塞性肺疾病相关因素Logistic回归分析  

Logistic regression analysis of chronic obstructive pulmonary disease related factors in non-smokers

作　　者：李晓娜 何碧玉 王建明 钦佩 邓笑伟[4] 周芊池 张群 LI Xiaona;HE Biyu;WANG Jianming;QIN Pei;DENG Xiaowei;ZHOU Qianchi;ZHANG Qun(Health Management Center,the First Affiliated Hospital with Nanjing Medical University,Nanjing 210029;Shanghai Municipal Center for Health Promotion,Shanghai 200040;Department of Epidemiology,Department of Social Medicine and Health Education,School of Public Health,Nanjing Medical University,Nanjing 211166;Health Medical Center,the Third Medical Center of Chinese PLA General Hospital,Beijing 100039;Health Management Center,Nanjing BenQ Hospital,Nanjing 210019,China)

机构地区：[1]南京医科大学第一附属医院健康管理中心,江苏南京210029 [2]上海市健康促进中心,上海200040 [3]南京医科大学公共卫生学院流行病学系,全球健康中心,江苏南京211166 [4]解放军总医院第三医学中心健康医学中心,北京100039 [5]南京明基医院健康管理中心,江苏南京210019

出　　处：《南京医科大学学报（自然科学版）》2021年第8期1239-1244,共6页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省科技厅社会发展公共卫生面上项目(BE2016787);江苏省卫生计生科研项目(H2017019);江苏省高校自然科学研究面上项目(19KJB320010)。

摘　　要：目的:探讨非吸烟人群慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)的相关因素,为制定早期筛查指标提供依据。方法:从南京医科大学第一附属医院健康管理中心和呼吸内科共招募2 440例30岁以上既往无COPD确诊史的非吸烟人群为调查对象,采用问卷调查收集相关因素,应用症状结合肺功能检测诊断COPD。组间比较连续变量采用独立样本t检验,类别变量采用卡方检验或Kruskal-Wallis H检验,关联强度采用Logistic回归模型估计并用OR(95%CI)表示。结果:单因素Logistic回归分析校正年龄性别后,文化程度低、低收入、居住在农村或郊区、长期接触粉尘或化学毒物、长期接触生物燃料或油烟等室内空气污染、儿童期有慢性呼吸道疾病史、天气变化时经常咳嗽、喘憋、活动后易气短与COPD关联具有统计学意义。多因素逐步回归分析显示,年龄60岁及以上、体重指数(BMI)较低、儿童期有慢性呼吸道疾病史、长期接触粉尘或化学毒物、不感冒时经常咳嗽、喘憋、活动后易气短与COPD的关联具有统计学意义。结论:年龄60岁及以上、BMI较低、儿童期有慢性呼吸道疾病史、长期接触粉尘或化学毒物、不感冒时经常咳嗽、喘憋、活动后易气短与非吸烟人群COPD有关,可针对具有这类特征的人群开展早期筛查和干预。Objective:This study aims to explore the related factors of chronic obstructive pulmonary disease(COPD)in non-smokers,and provide a basis for the development of early screening indicators. Methods:A total of 2 440 non-smokers above 30 years old without history of COPD were recruited from the Health Management Center and Department of Respiratory Medicine of the First Affiliated Hospital with Nanjing Medical University. Questionnaires were used to collect related factors. Symptoms combined with lung function test were used to diagnose COPD. The independent-sample t test was used to compare continuous variables between groups,and the chi-square test or Kruskal-Wallis H test was used for categorical variables,and the correlation strength was estimated by logistic regression model and expressed by OR(95% CI). Results:After adjusting for age and gender by single factor logistic regression analysis,low education level,low income,living in rural or suburban areas,long-term exposure to dust or chemical poisons,long-term exposure to indoor air pollution such as bio-fuels or oil fume,history of chronic respiratory diseases in childhood,frequent coughing,wheezing and shortness of breath after activities were significantly associated with COPD. Multivariate stepwise regression analysis showed that age of 60 and above,low BMI,history of chronic respiratory disease in childhood,long-term exposure to dust or chemical toxins,frequent coughing when not having a cold,wheezing,and shortness of breath after activities were significantly associated with COPD. Conclusion:Age of 60 and above,low BMI,history of chronic respiratory diseases in childhood,long-term exposure to dust or chemical poisons,frequent coughing when not having a cold,wheezing,shortness of breath after activities are related to COPD in non-smokers. Early screening and intervention should be carried out for people with such characteristics.

关 键 词：非吸烟人群 慢性阻塞性肺疾病 危险因素 

分 类 号：R563.3[医药卫生—呼吸系统]