慢性阻塞性肺疾病患者体力活动水平及影响因素分析的中英比较研究  

Comparative study on physical activity and its influencing factors in patients with chronic pulmonary obstructive disease between China and the United Kingdom

作　　者：史洪静 蒋家诺 吕筠[1,3,4] 陈媛媛 邵子伦 孙点剑一 李立明[1,3,4] 余灿清[1,3,4] Shi Hongjing;Jiang Jianuo;Lyu Jun;Chen Yuanyuan;Shao Zilun;Sun Dianjianyi;Li Liming;Yu Canqing(Department of Epidemiology and Biostatistics,School of Public Health,Peking University,Beijing 100191,China;Institute of Child and Adolescent Health,Peking University/School of Public Health,Peking University,Beijing 100191,China;Peking University Center for Public Health and Epidemic Preparedness&Response,Beijing 100191,China;Key Laboratory of Epidemiology of Major Diseases(Peking University),Ministry of Education,Beijing 100191,China)

机构地区：[1]北京大学公共卫生学院流行病与卫生统计学系,北京100191 [2]北京大学公共卫生学院/北京大学儿童青少年卫生研究所,北京100191 [3]北京大学公众健康与重大疫情防控战略研究中心,北京100191 [4]重大疾病流行病学教育部重点实验室(北京大学),北京100191

出　　处：《中华流行病学杂志》2023年第12期1851-1857,共7页Chinese Journal of Epidemiology

基　　金：国家自然科学基金(82192901,82192904,82192900);国家重点研发计划“精准医学研究”重点专项(2016YFC0900500);中国香港Kadoorie Charitable基金。

摘　　要：目的比较中英慢性阻塞性肺疾病(COPD)患者体力活动水平及影响因素差异。方法利用中国慢性病前瞻性研究和英国生物银行基线调查数据,以一秒率(FEV1/FVC)<70%作为COPD诊断标准,以代谢当量(MET)作为体力活动水平的衡量指标并按性别、年龄分层的MET值三分位数分为低、中、高3级,分别使用多元逐步logistic回归探究体力活动水平与COPD及慢性阻塞性肺疾病全球倡议(GOLD)分级的关系,并进行亚组分析。结果共纳入506073名中国成年人和231884名英国成年人为研究对象。与非COPD人群相比,中英COPD患者低水平体力活动的OR值(95%CI)分别为1.07(1.03~1.10)、1.03(1.01~1.06);GOLD分级与体力活动水平呈负相关,且在中国人群中存在线性趋势(趋势检验P<0.001)。亚组分析显示,中英人群中高龄、受教育年限少、经济水平低、过去吸烟、有呼吸系统疾病史的COPD患者体力活动水平下降的可能性更大。中国农村COPD患者体力活动下降的可能性更大。结论COPD与体力活动水平呈负相关,且GOLD分级与体力活动水平呈剂量反应关系,应鼓励和促进COPD患者尤其高危人群多进行体力活动。Objective To compare physical activity and its influencing factors in patients with chronic obstructive pulmonary disease(COPD)between China and the United Kingdom.Methods We analyzed baseline data from China Kadoorie Biobank and the United Kingdom Biobank among COPD patients who were diagnosed with a one-second rate(FEV1/FVC)less than 70%.Physical activity level was calculated as metabolic equivalent(MET)and divided into three levels:low,medium,and high,according to tertiles stratified by gender and age.Multiple logistic regression was used to estimate ORs and 95%CIs for COPD and Global Initiative for Chronic Obstructive Lung Disease(GOLD)grade about physical activity level,and subgroup analysis was conducted.Results A total of 506073 Chinese adults and 231884 British adults were included.After adjusting for potential confounders,COPD was associated with lower physical activity levels in both Chinese and British COPD patients,with OR(95%CI)of 1.07(1.03-1.10)and 1.03(1.01-1.06)compared with non COPD patients,respectively.The GOLD grade was inversely correlated with physical activity level,particularly in a dose-response manner in the CKB population(trend test P<0.001).The negative relationship was stronger among the elderly,people with less education and lower economic status,and those with a smoking or chronic disease history.Chinese rural COPD patients were at high risk of decline of physical activity.Conclusions Physical activity is inversely related to COPD,with a dose-response connection to GOLD grade.Therefore,physical activity maintenance and improvement should be encouraged and promoted in COPD patients,especially in high-risk groups.

关 键 词：慢性阻塞性肺疾病 体力活动 影响因素 跨国比较 

分 类 号：R563.9[医药卫生—呼吸系统]