结核与肺部疾病杂志 ›› 2024, Vol. 5 ›› Issue (6): 517-525.doi: 10.19983/j.issn.2096-8493.2024120

• 论著 • 上一篇    下一篇

深圳市南山区≥40岁常住居民慢性阻塞性肺疾病知识知晓情况及患病率影响因素分析

杨亚蕊, 郭旭君, 魏巍, 何娟, 李盛斌, 钟涛, 高婉玲, 刘守江, 刘盛元()   

  1. 深圳市南山区慢性病防治院结核病防治科,深圳 518064
  • 收稿日期:2024-07-15 出版日期:2024-12-20 发布日期:2024-12-11
  • 通信作者: 刘盛元 E-mail:liushenglb@126.com
  • 基金资助:
    南山区科技计划项目(医疗卫生类)(NS2022056);广东省医学科学技术研究基金项目(A2023158);广东省医学科学技术研究基金项目(C2023106)

Awareness and factors associated with chronic obstructive pulmonary disease among permanent residents aged ≥40 years old in Nanshan District, Shenzhen

Yang Yarui, Guo Xujun, Wei Wei, He Juan, Li Shengbin, Zhong Tao, Gao Wanling, Liu Shoujiang, Liu Shengyuan()   

  1. Department of Tuberculosis Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518064, China
  • Received:2024-07-15 Online:2024-12-20 Published:2024-12-11
  • Contact: Liu Shengyuan E-mail:liushenglb@126.com
  • Supported by:
    Nanshan District Science and Technology Project (Medical and Health)(NS2022056);Medical Science and Technology Research Fund Project of Guangdong Province(A2023158);Medical Science and Technology Research Fund Project of Guangdong Province(C2023106)

摘要:

目的: 调查南山区≥40岁常住居民对慢性阻塞性肺疾病(COPD)的知晓和患病情况,并分析COPD患病的影响因素,为制定COPD防控措施提供依据。方法: 采用多阶段分层随机抽样方法,于2018年10—12月随机抽取深圳市南山区2个街道中的5个社区,每个社区随机抽取100~120户居民家庭,采用随机数字表法在每户居民家庭中随机抽取1名≥40岁的常住居民进行问卷调查、肺功能检查及COPD评估测试(CAT)。调查问卷包括调查对象基本信息、COPD知识知晓情况(包括COPD疾病名称、肺功能检查和COPD相关知识知晓情况)、既往疾病史、呼吸道症状、危险因素暴露和既往肺功能检查情况等,采用单因素和多因素logistic回归模型分析居民COPD患病率影响因素。结果: 共收集到南山区555名调查对象相关资料。调查对象对COPD疾病名称、肺功能检查和COPD相关知识的知晓率分别为27.39%(152/555)、18.92%(105/555)和19.10%(106/555)。其中,高中及以上文化程度、专业技术人员对COPD疾病名称、肺功能检查和COPD相关知识的知晓率[29.68%(111/374)、21.39%(80/374)、21.12%(79/374);47.06%(24/51)、37.25%(19/51)、37.25%(19/51)]均高于小学及以下文化程度、从事农林牧渔水利生产的调查对象[14.71%(10/68)、8.82%(6/68)、7.35%(5/68);1/6、0、0],差异均有统计学意义(χ2=5.430, P=0.020; χ2=6.178, P=0.013; χ2=5.721, P=0.017; χ2=20.490, P=0.009; χ2=22.750, P=0.004; χ2=27.087,P=0.001)。COPD检出率为9.73%(54/555),其中,轻、中、重度分别为40例(74.07%)、11例(20.37%)和3例(5.56%);检出患者的CAT得分的中位数(四分位数)为3.0(1.0,5.0)分,且随疾病严重程度的不同而有明显差异(H=7.779,P=0.020)。多因素logistic回归分析结果显示,70~78岁、有哮喘和慢性支气管炎病史均是南山区居民罹患COPD的危险因素[OR(95%CI)=3.448(1.036~11.479);OR(95%CI)=5.149(1.481~17.902);OR(95%CI)=2.646(1.005~6.965)]。结论: 南山区≥40岁常住居民COPD核心知识知晓率偏低,建议采取COPD综合健康促进措施提升辖区居民对COPD相关知识知晓水平,尤其是文化程度低、无固定工作场所人员;另外,COPD检出情况并不乐观,应警惕辖区COPD年轻化趋势,积极开展COPD早诊早治措施,尤其是扩大高龄、有哮喘和慢性支气管炎病史居民的早期筛查覆盖面。

关键词: 肺疾病,慢性阻塞性, 问卷调查, 患病率, 因素分析,统计学

Abstract:

Objective: To investigate the prevalence of chronic obstructive pulmonary disease (COPD) among permanent residents aged ≥40 years in Nanshan District, Shenzhen, the awareness of COPD, and to analyze the factors associated with the COPD, so as to provide evidence for development of COPD prevention and control measures. Methods: A multi-stage stratified random sampling method was used to select 5 communities from 2 sub-districts in Nanshan District, Shenzhen from October to December, 2018. 100 to 120 families were randomly selected from each community, and one permanent resident aged ≥40 years old was randomly selected from each family to conduct the questionnaire survey, pulmonary function test and COPD assessment test (CAT) using the random sampling table method. The questionnaire included the basic information of the subjects, the awareness of knowledge of COPD (including COPD disease name and COPD related knowledge), previous disease history, respiratory symptoms, status of risk factor exposure and results of previous pulmonary function examination. Univariate and multivariate logistic regression models were used to analyze the influencing factors of COPD prevalence in residents. Results: A total of 555 subjects were collected in Nanshan district. The awareness of knowledge of COPD disease name, pulmonary function examination and COPD related knowledge were 27.39% (152/555), 18.92% (105/555) and 19.10% (106/555), respectively. The awareness rates of COPD disease name, pulmonary function test and COPD related knowledge among subjects with high school education or above and, the technical personnel (29.68% (111/374), 21.39% (80/374), and 21.12% (79/374); 47.06% (24/51), 37.25% (19/51), and 37.25% (19/51)) were higher than those with primary school education or less and engaged in agricultural/forestry/animal husbandry/fishery/water conservancy production (14.71% (10/68), 8.82% (6/68), and 7.35% (5/68); 1/6, 0, 0), and the differences were statistically significant (χ2=5.430, P=0.020; χ2=6.178, P=0.013; χ2=5.721, P=0.017; χ2=20.490, P=0.009; χ2=22.750, P=0.004; χ2=27.087, P=0.001). The rate of COPD was 9.73% (54/555), with 40 cases (74.07%) being mild, 11 cases (20.37%) being moderate and 3 cases (5.56%) being severe. The mean CAT score of the COPD patients was 3.0 (1.0, 5.0), and there was association between the score and the severity of the disease (H=7.779, P=0.020). Multivariate logistic regression analysis showed that persons aged 70-78 years old and with history of asthma and chronic bronchitis were risk factors for COPD in Nanshan District residents (OR (95%CI)=3.448 (1.036-11.479); OR (95%CI)=5.149 (1.481-17.902); OR (95%CI)=2.646 (1.005-6.965)). Conclusion: The awareness of COPD core knowledge among permanent residents aged ≥40 years old in Nanshan District is low. It is recommended to take comprehensive COPD health promotion measures to improve the awareness level of COPD related knowledge among residents, especially those with low education level and no fixed workplace. The detection of COPD is not optimistic. The trend of younger patients with COPD should be paid attention. We should actively carry out early diagnosis and treatment measures for COPD, especially expanding the coverage of early screening for elderly residents and residents with a history of asthma and chronic bronchitis.

Key words: Chronic obstructive pulmonary disease, Questionnaires, Prevalence rate, Factor analysis, statistical

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