上海市松江区40岁及以上社区女性居民生殖健康因素与肺功能及慢性阻塞性肺疾病的关联  

Associations of reproductive health indicators with lung function and COPD among female community residents aged 40 years and above in Songjiang District,Shanghai

作　　者：尹欣 吴毅凌[2] 侯珊珊 李静 罗炜 俞敏君 臧金鑫 王伟 苏旭燕[2] 赵琦[1] 朱寅峰 赵根明[1] 姜永根[2] 姜庆五[1] 王娜[1] YIN Xin;WU Yi-ling;HOU Shan-shan;LI Jing;LUO Wei;YU Min-jun;ZANG Jin-xin;WANG Wei;SU Xu-yan;ZHAO Qi;ZHU Yin-feng;ZHAO Gen-ming;JIANG Yong-gen;JIANG Qing-wu;WANG Na(Key Laboratory of Public Health Safety of Ministry of Education-Department of Epidemiology,School of Public Health,Fudan University,Shanghai 200032,China;Shanghai Songjiang Center for Disease Control and Prevention,Shanghai 201620,China;Shanghai Songjiang District Zhongshan Street Community Health Service Center,Shanghai 201613,China;Shanghai Songjiang District Maogang Town Community Health Service Center,Shanghai 201607,China;Shanghai Songjiang District Xinqiao Town Community Health Service Center,Shanghai 201612,China;Shanghai Songjiang District Sheshan Town Community Health Service Center,Shanghai 201602,China)

机构地区：[1]复旦大学公共卫生学院流行病学教研室-公共卫生安全教育部重点实验室,上海200032 [2]上海市松江区疾病预防控制中心,上海201620 [3]上海市松江区中山街道社区卫生服务中心,上海201613 [4]上海市松江区泖港镇社区卫生服务中心,上海201607 [5]上海市松江区新桥镇社区卫生服务中心,上海201612 [6]上海市松江区佘山镇社区卫生服务中心,上海201602

出　　处：《复旦学报（医学版）》2024年第6期882-889,共8页Fudan University Journal of Medical Sciences

基　　金：国家自然科学基金(82073634);上海市加强公共卫生体系建设三年(2023—2025)行动计划(GWVI-11.1-23)。

摘　　要：目的探究女性生殖健康因素与肺功能和慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)的关联。方法2021年7—9月从松江区自然人群队列随机抽取40岁及以上女性居民开展COPD筛查,问卷获取一般情况和生殖健康因素信息,使用线性回归分析生殖健康因素对用力肺活量(forced vital capacity,FVC)和1秒用力呼气容积(forced expiratory volume in the first second,FEV1)的影响;使用Logistic回归分析生殖健康因素对FVC、FEV1占预计值的百分比和对COPD的影响。结果共纳入1876例40岁及以上女性,其中78.1%已绝经,40.9%怀孕≥3次。多因素分析结果显示,绝经女性FVC和FEV1下降,但与其预计值百分比的下降无关;怀孕≥3次是COPD患病的危险因素(怀孕3次:OR=4.92,95%CI为1.48~19.95,P<0.05;怀孕≥4次:OR=9.06,95%CI为2.32~41.57,P<0.01),怀孕2次不会增加COPD患病风险。结论在40岁及以上女性中,绝经会引起FVC和FEV1下降,怀孕≥3次是患COPD的危险因素。Objective To investigate the associations of reproductive health indicators with lung function and chronic obstructive pulmonary disease(COPD)among women aged 40 years and above.Methods From Jul to Sep,2021,female subjects aged 40 years and above were randomly selected from the Shanghai Suburban Adult Cohort and Biobank for COPD screening.A questionnaire was used to obtain information on demographic characteristics and reproductive health indicators.Linear regression was used to analyze the effects of reproductive health indicators on forced vital capacity(FVC)and forced expiratory volume in the first second(FEV1).Logistic regression was also used to analyze the effects of reproductive health factors on FVC as a percentage of the predicted value(FVC%Pred)and FEV1%Pred as well as on COPD.Results A total of 1876 women aged 40 years and above were enrolled with mean age of(62.1±8.2)years old,among them,78.1%were menopausal,and 40.9%had been pregnant≥3 times.Multivariate analysis showed that FVC and FEV1 decreased in postmenopausal women,but menopause was not associated with a decrease in their percentage of predicted values.Pregnancies≥3 times was a risk factor for COPD(for 3 times,OR=4.92,95%CI:1.48-19.95,P<0.05;for≥4 times,OR=9.06,95%CI:2.32-41.57,P<0.01),while pregnancies of 2 times did not increase the risk of COPD.Conclusion In women aged 40 years and above,menopause is associated with poorer FVC and FEV1,and excessive pregnancy(≥3 times)is a risk factor for COPD.

关 键 词：慢性阻塞性肺疾病(COPD) 肺功能 生殖健康 绝经 妊娠 

分 类 号：R715.5[医药卫生—妇产科学] R563.5[医药卫生—临床医学]