社区慢性阻塞性肺疾病高危人群问卷筛查研究  

Questionnaire screening for high-risk population of chronic obstructive pulmonary disease in a community

作　　者：顾汝英 钟华 蒋海燕 孙克玉[2] GU Ruying;ZHONG Hua;JIANG Haiyan;SUN Keyu(Hongqiao Community Health Service Center of Minhang District,Shanghai Medical College,Fudan University,Shanghai 201103,China;Minhang Hospital Affiliated to Fudan University,Shanghai 201199,China)

机构地区：[1]复旦大学上海医学院闵行区虹桥社区卫生服务中心,上海201103 [2]复旦大学附属闵行医院,上海201199

出　　处：《实用预防医学》2024年第12期1428-1432,共5页Practical Preventive Medicine

基　　金：上海市闵行区卫生健康委员会科研项目(2022MW42)

摘　　要：目的 分析慢性阻塞性肺疾病(简称慢阻肺)人群筛查问卷(Chronic Obstructive Pulmonary Disease Population Screener Questionnaire, COPD-PS)筛查社区高危人群现状,探讨问卷的有效性。方法 采用随机整群抽样法,于2023年3—5月选取上海某社区≥35岁居民1 306人进行COPD-PS筛查,内容包括气短、咳痰、活动受限、吸烟史、年龄共5个评分项目。同时对人口学信息、个人及家族呼吸系统疾病史进行调查。以问卷评分≥5分为慢阻肺高危。采用Cronbach模型、相关分析、因子分析对量表进行信效度分析。χ^(2)检验和logistic回归分析高危人群分布及危险因素。结果 COPD-PS Cronbach’s α=0.72,KMO=0.76。验证性因子分析模型各指标拟合效果良好。调查人群慢阻肺高危比例为16.54%(95%CI:14.56%~18.67%)。高危人群以男性、年龄≥60岁、低学历、离退休、有吸烟史、有既往呼吸系统疾病史及家族史人群占比较高(均P<0.001)。logistic回归分析显示,高龄(OR_(60~69岁)=103.825,95%CI:40.417~266.710;OR_(≥70岁)=110.634,95%CI:41.263~296.625)、有吸烟史(OR=3.272,95%CI:2.657~4.029)、有既往呼吸系统疾病史(OR=2.598,95%CI:1.737~3.885)为慢阻肺高危的独立危险因素。结论 COPD-PS是一种简短有效的问卷,能识别一般人群中可能患慢阻肺的个体,适合社区初筛应用。社区慢阻肺高危筛查应重点关注年龄≥60岁、吸烟史、既往呼吸系统疾病史人群。Objective To analyze the current status of screening for high-risk population with the Chronic Obstructive Pulmonary Disease Population Screener Questionnaire(COPD-PS)in a community,and to explore the validity of the questionnaire.Methods A random cluster sampling method was used to select 1,306 residents aged≥35 years in a community in Shanghai in March-May 2023.COPD-PS was employed to perform the screening,and the contents included 5 scoring items like shortness of breath frequency,production of sputum,functional limitations due to breathing problems,smoking history and age.Demographic information,personal and family respiratory system disease histories were also investigated simultaneously.And residents with the score≥5 points were defined as the population at high risk of COPD.Cronbach model,correlation analysis and factor analysis were applied to analyzing the reliability and validity of the scale.χ^(2) test and logistic regression analysis were performed to analyze the distribution of high-risk population and risk factors.Results Analysis results based on the COPD-PS revealed that Cronbach’sαwas 0.72,and KMO was 0.76.The confirmatory factor analysis model had good fitting results for all indicators.The high-risk proportion of COPD among the surveyed population was 16.54%(95%CI:14.56%-18.67%).The proportion of high-risk population was relatively high among males,residents aged 60 years and above,residents with low education,the retired,residents having a history of smoking,residents having a previous history of respiratory system disease and residents having a family history of respiratory system disease(all P<0.001).Logistic regression analysis displayed that advanced age(OR_(60-69 years old)=103.825,95%CI:40.417-266.710;OR_(≥70 years old)=110.634,95%CI:41.263-296.625),having a history of smoking(OR=3.272,95%CI:2.657-4.029)and having a previous history of respiratory system disease(OR=2.598,95%CI:1.737-3.885)were independent risk factors for high-risk COPD.Conclusion The COPD-PS is a brief and eff

关 键 词：慢性阻塞性肺疾病 高危人群 问卷 筛查 社区 

分 类 号：R563[医药卫生—呼吸系统]