摘要
目的研究北京市石景山区10家社区40岁及以上居民吸烟、二手烟暴露与慢性阻塞性肺疾病(以下简称“慢阻肺”)的关系。方法采用随机抽样方法对北京市石景山区10家社区40岁及以上居民进行调查问卷、身体测量及吸入支气管舒张药物前后肺功能检查等,对获得的数据进行统计学分析。结果共有4096名监测对象被纳入最终研究,总体慢阻肺患病率为10.2%(95%CI:9.2~11.1),吸烟人群慢阻肺的患病率(15.8%,95%CI:13.9~17.7)明显高于非吸烟人群(7.2%,95%CI:6.2~8.2),且男性患病率(16.6%,95%CI:14.6~18.6)高于女性(8.3%,95%CI:3.8~12.9)。工作环境中接触二手烟的男性慢阻肺患病率(10.6%,95%CI:6.7~14.4)高于工作中无二手烟接触者(6.1%,95%CI:3.6~8.5)。与不吸烟的慢阻肺患者相比,曾经吸烟或现在吸烟的慢阻肺患者出现症状的比率较高,且肺功能较差。调整相关因素后,相对于从不吸烟者,男性人群中过去吸烟者(OR=9.242,95%CI:6.406~13.332,P<0.001)和现在吸烟者(OR=1.672,95%CI:1.476~1.949,P=0.024)发生慢阻肺的风险增加,女性人群中过去吸烟者患慢阻肺的风险也显著增加(OR=1.167,95%CI:1.081~1.344,P<0.001);相对于无二手烟暴露者,女性暴露于二手烟环境发生慢阻肺的风险增加(OR=1.442,95%CI:1.190~1.787,P=0.027)。结论北京市石景山区10家社区40岁及以上居民慢阻肺患病率偏高,吸烟是慢阻肺的主要危险因素,且吸烟、二手烟暴露对慢阻肺患者的症状和肺功能亦有影响,控烟戒烟仍是慢阻肺防控的重中之重。
Objective To investigate the association of smoking and second-hand smoking with the prevalence of chronic obstructive pulmonary disease(COPD)among residents aged 40 years or above in 10 communities in Shijingshan District of Beijing City.Methods This study made a survey of the residents aged 40 years or above in 10 communities of Shijingshan District by random sampling method.Questionnaire survey,physical measurement,and pulmonary function examination before and after bronchodilator use were conducted in all subjects.The data were analyzed statistically.Results A total of 4096 participants had reliable post-bronchodilator results and were included in the final analysis,the overall prevalence of COPD was 10.2%(95%CI:9.2-11.1).The prevalence of COPD was significantly higher in smokers(15.8%,95%CI:13.9-17.7)than in non-smokers(7.2%,95%CI:6.2-8.2),and in men(16.6%,95%CI:14.6-18.6)than in women(8.3%,95%CI:3.8-12.9).The prevalence of COPD in men exposed to second-hand smoking in work environment(10.6%,95%CI:6.7-14.4)was higher than that of men without exposure(6.1%,95%CI:3.6-8.5).Compared to COPD patients who never smoked,both former and current smokers had a higher incidence of symptoms and poorer lung function.After adjusting for the related factors,compared with non-smokers,the prevalence of COPD among former smokers(OR=9.242,95%CI:6.406-13.332,P<0.001)and current smokers(OR=1.672,95%CI:1.476-1.949,P=0.024)in male participants were higher,and the prevalence among former smokers in female participants also increased significantly(OR=1.167,95%CI:1.081-1.344,P<0.001).The prevalence of COPD was higher in female exposed to secondhand smoking than in those without(OR=1.442,95%CI:1.190-1.787,P=0.027).Conclusion There is a high prevalence of COPD in Shijingshan residents aged 40 years or above.Smoking is the main risk factor for COPD.Smoking and second-hand smoking also affects the symptoms and lung function of COPD patients.Smoking control is still the top priority of COPD prevention and control.
作者
赵璨
孙培培
张二明
安欣华
马石头
刘力勇
向平超
Zhao Can;Sun Peipei;Zhang Erming;An Xinhua;Ma Shitou;Liu Liyong;Xiang Pingchao(Department of Respiratory and Critical Care Medicine,Peking University Shougang Hospital,Beijing 100144,China;Center for Disease Control and Prevention of Shijingshan District,Beijing 100043,China)
出处
《中华临床医师杂志（电子版）》
CAS
北大核心
2021年第6期450-458,共9页
Chinese Journal of Clinicians(Electronic Edition)
关键词
慢性阻塞性肺疾病
患病率
吸烟
二手烟暴露
Chronic obstructive pulmonary disease
Prevalence
Smoking
Second-hand smoking
作者简介
通信作者:向平超,Email:xpcemail@163.com。
