新疆喀什地區(qū)COPD危險因素的病例—對照研究
發(fā)布時間：2018-08-03 09:41
【摘要】：目的：分析新疆喀什地區(qū)慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)的相關(guān)危險因素,以及COPD患者生活質(zhì)量的影響因素；為新疆喀什地區(qū)COPD的防治和制定相應(yīng)的健康政策和策略提供科學(xué)依據(jù)。方法：本研究采用以醫(yī)院為基礎(chǔ)的病例對照研究方法,用統(tǒng)一的調(diào)查表對病例及對照的病歷資料進行調(diào)查。病例來源于2011年3月到2012年6月在新疆喀什地區(qū)第二人民醫(yī)院經(jīng)診斷符合慢性阻塞性肺疾病全球防治倡議(Global Initiative for Chronic Obstructive Lung Disease,GOLD)診斷標準COPD患者。從同期在喀什地區(qū)第二人民醫(yī)院非呼吸科就診患者中,選擇同性別、族別、年齡與COPD患者相差在5歲以內(nèi),無慢性呼吸系統(tǒng)及嚴重心、肝、腎疾病者作為對照。調(diào)查內(nèi)容參考GOLD委員會疾病COPD負擔研究專題的流行病學(xué)調(diào)查問卷,考慮喀什地區(qū)文化背景和人文素質(zhì)進行語言調(diào)整,內(nèi)容包括人口學(xué)基本資料、家族肺部疾病史、吸煙和被動吸煙暴露、粉塵接觸、廚房通風(fēng)、燃料、有無抽油煙機、營養(yǎng)狀況、飲食習(xí)慣等25個項目及數(shù)個子項目。運用COPD Assessment Test(CAT)量表對COPD患者的生活質(zhì)量進行評價,并分析其影響因素。所有數(shù)據(jù)均使用Epi Data軟件進行錄入和管理。應(yīng)用SPSS20.0軟件進行統(tǒng)計分析。采用單因素非條件Logistic回歸分析和多因素非條件Logistic回歸分析確定各種危險因素與喀什地區(qū)人群COPD發(fā)生的相關(guān)性,以優(yōu)勢比(OR)及其95%置信區(qū)間(95%CI)表示；所有檢驗均采用雙尾和a0.05水平為有統(tǒng)計學(xué)意義。 結(jié)果：共有256例患者參與本研究,其中漢族42例(16.4%),維吾爾族214例(83.6%),病例組和對照組各128例,每組均為漢族21例(16.4%)、維吾爾族107例(83.6%)。平均年齡(63.3±10.1)歲,其中病例組組為(62.7±10.5)歲,對照組為(64.0±9.7)歲,兩組的性別、年齡、文化程度等人口特征構(gòu)成均無統(tǒng)計學(xué)差異(p0.05)。單因素分析結(jié)果顯示：BMI、營養(yǎng)狀況、燒煤燒柴指數(shù)、冬季采暖方式、粉塵接觸、廚房控油煙裝置、廚房通風(fēng)、吸煙、家庭被動吸煙、工作場所被動吸煙、呼吸道疾病家族史共計11個因素與COPD發(fā)病有關(guān)(p0.05)。多因素分析結(jié)果顯示：營養(yǎng)不良(OR=6.4,95%CI：3.3-8.7)、高燒煤燒柴指數(shù)(OR=7.6,95%CI：3.7-9.3)、吸煙(OR=6.5,95%CI：1.9-22.2)、家庭被動吸煙(OR=2.2,95%CI：1.5-10.0)和工作場所被動吸煙(OR=8.2,95%CI：1.2-56.6)、粉塵接觸是COPD發(fā)病的主要危險因素；廚房通風(fēng)是COPD發(fā)病的保護因素。多因素線性回歸模型分析結(jié)果顯示：燒煤燒柴指數(shù)(β=1.973,95%CI：0.126-3.820)、粉塵接觸(β=2.982,95%CI：0.956-5.009)、和吸煙(β=1.557,95%CI：0.374-3.487)與CAT得分呈正相關(guān)(p0.05),廚房通風(fēng)(β=-2.314,95%CI：-3.546--1.081)、FEV1%(β=-0.082,95%CI：-0.144--0.021)和FEV1/FVC(β=-0.126,95%CI：-0.234--0.081)與CAT呈負相關(guān)(p0.05)。 結(jié)論：燒煤燒柴指數(shù)、粉塵接觸是新疆喀什地區(qū)COPD發(fā)生的環(huán)境危險因素,而且與患者的生活質(zhì)量具有重要影響,特別是粉塵接觸與COPD患病呈現(xiàn)劑量反應(yīng)關(guān)系；吸煙和被動吸煙是新疆喀什地區(qū)居民COPD發(fā)病的行為危險因素,而且對患者的肺功能和生活質(zhì)量有影響；營養(yǎng)狀況與COPD患病風(fēng)險呈正相關(guān),是COPD發(fā)病的危險因素；廚房通風(fēng)不但是COPD發(fā)病的保護因素,而且廚房通風(fēng)良好有助于提高患者的生活質(zhì)量。
[Abstract]:Objective: to analyze the related risk factors of chronic obstructive pulmonary disease (Chronic Obstructive Pulmonary Disease, COPD) in Kashi, Xinjiang, and the influencing factors of the quality of life of COPD patients; to provide scientific basis for the prevention and control of COPD in Kashi region of Xinjiang and the formulation of corresponding health policies and Strategies. The basic case control study was conducted using a unified questionnaire to investigate the case and control data. The cases were diagnosed by the Global Initiative for Chronic Obstructive Lung Disease, GOLD, which was diagnosed in the second people's Hospital in Kashi, Xinjiang, from March 2011 to June 2012. Diagnostic criteria COPD patients were selected from the same sex, family, age and COPD patients in the non Department of respiration at the second people's Hospital of Kashi in the same period. There was no chronic respiratory system and serious heart, liver, kidney disease as control. The investigation content referred to the epidemiological survey on the research topic of the disease COPD burden of the GOLD Committee. The questionnaire, taking into account the cultural background and humanistic quality of the Kashi region, made the language adjustment, including the basic data of demography, family lung disease history, smoking and passive smoking exposure, dust exposure, kitchen ventilation, fuel, oil smoker, nutritional status, dietary habits, and other 25 items and several sub items. The use of COPD Assessment Test (CAT) The quality of life of COPD patients was evaluated and its influencing factors were analyzed. All data were recorded and managed by Epi Data software. SPSS20.0 software was used for statistical analysis. A single factor unconditional Logistic regression analysis and multi factor unconditional Logistic regression analysis were used to determine the various risk factors and COPD in Kashi population. The correlation was expressed by odds ratio (OR) and 95% confidence interval (95% CI); all tests were double-tailed and a0.05 levels for statistical significance.
Results: a total of 256 patients were enrolled in this study, including 42 (16.4%), 214 Uygur (83.6%), and 128 cases in the case group and the control group. Each group was 21 (16.4%) and 107 (83.6%) of the Uygur nationality (83.6%). The average age was (63.3 + 10.1) years, and the case group was (62.7 +) years of age, and the sex and age of the group. The demographic characteristics were not statistically different (P0.05). The results of single factor analysis showed that: BMI, nutritional status, burning coal burning firewood index, heating mode in winter, dust contact, kitchen oil control smoke device, kitchen ventilation, smoking, passive smoking at home, passive smoking in the workplace, and family history of respiratory diseases in total 11 factors and COPD hair. Disease related (P0.05). The results of multifactor analysis showed: malnutrition (OR=6.4,95%CI:3.3-8.7), high burning coal burning wood index (OR=7.6,95%CI:3.7-9.3), smoking (OR=6.5,95%CI:1.9-22.2), family passive smoking (OR=2.2,95%CI:1.5-10.0) and workplace passive smoking (OR =8.2,95%CI:1.2-56.6). Dust exposure was the main risk of COPD Factors; kitchen ventilation was a protective factor for the onset of COPD. The results of multi factor linear regression model showed that coal burning coal burning index (beta =1.973,95%CI:0.126-3.820), dust exposure (beta =2.982,95%CI:0.956-5.009), and smoking (beta =1.557,95%CI:0.374-3.487) were positively correlated with CAT (P0.05), and kitchen ventilation (beta =-2.314,95%CI:-3.546-) -1.081), FEV1% (beta =-0.082,95%CI:-0.144--0.021) and FEV1/FVC (beta =-0.126,95%CI:-0.234--0.081) were negatively correlated with CAT (P0.05).
Conclusion: the index of burning coal and burning coal, dust contact is the environmental risk factor of COPD in Kashi area of Xinjiang, and it has an important influence on the quality of life of patients, especially the relationship between dust exposure and COPD disease, smoking and passive smoking are the risk factors of COPD in the people of Kashi, Xinjiang and the patients. The pulmonary function and the quality of life have an influence. The nutritional status is positively related to the risk of COPD disease, which is a risk factor for the pathogenesis of COPD; the kitchen ventilation is not only a protective factor for the pathogenesis of COPD, but the good ventilation in the kitchen can help to improve the quality of life of the patients.
【學(xué)位授予單位】：復(fù)旦大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R563.9
本文編號：2161347
[Abstract]:Objective: to analyze the related risk factors of chronic obstructive pulmonary disease (Chronic Obstructive Pulmonary Disease, COPD) in Kashi, Xinjiang, and the influencing factors of the quality of life of COPD patients; to provide scientific basis for the prevention and control of COPD in Kashi region of Xinjiang and the formulation of corresponding health policies and Strategies. The basic case control study was conducted using a unified questionnaire to investigate the case and control data. The cases were diagnosed by the Global Initiative for Chronic Obstructive Lung Disease, GOLD, which was diagnosed in the second people's Hospital in Kashi, Xinjiang, from March 2011 to June 2012. Diagnostic criteria COPD patients were selected from the same sex, family, age and COPD patients in the non Department of respiration at the second people's Hospital of Kashi in the same period. There was no chronic respiratory system and serious heart, liver, kidney disease as control. The investigation content referred to the epidemiological survey on the research topic of the disease COPD burden of the GOLD Committee. The questionnaire, taking into account the cultural background and humanistic quality of the Kashi region, made the language adjustment, including the basic data of demography, family lung disease history, smoking and passive smoking exposure, dust exposure, kitchen ventilation, fuel, oil smoker, nutritional status, dietary habits, and other 25 items and several sub items. The use of COPD Assessment Test (CAT) The quality of life of COPD patients was evaluated and its influencing factors were analyzed. All data were recorded and managed by Epi Data software. SPSS20.0 software was used for statistical analysis. A single factor unconditional Logistic regression analysis and multi factor unconditional Logistic regression analysis were used to determine the various risk factors and COPD in Kashi population. The correlation was expressed by odds ratio (OR) and 95% confidence interval (95% CI); all tests were double-tailed and a0.05 levels for statistical significance.
Results: a total of 256 patients were enrolled in this study, including 42 (16.4%), 214 Uygur (83.6%), and 128 cases in the case group and the control group. Each group was 21 (16.4%) and 107 (83.6%) of the Uygur nationality (83.6%). The average age was (63.3 + 10.1) years, and the case group was (62.7 +) years of age, and the sex and age of the group. The demographic characteristics were not statistically different (P0.05). The results of single factor analysis showed that: BMI, nutritional status, burning coal burning firewood index, heating mode in winter, dust contact, kitchen oil control smoke device, kitchen ventilation, smoking, passive smoking at home, passive smoking in the workplace, and family history of respiratory diseases in total 11 factors and COPD hair. Disease related (P0.05). The results of multifactor analysis showed: malnutrition (OR=6.4,95%CI:3.3-8.7), high burning coal burning wood index (OR=7.6,95%CI:3.7-9.3), smoking (OR=6.5,95%CI:1.9-22.2), family passive smoking (OR=2.2,95%CI:1.5-10.0) and workplace passive smoking (OR =8.2,95%CI:1.2-56.6). Dust exposure was the main risk of COPD Factors; kitchen ventilation was a protective factor for the onset of COPD. The results of multi factor linear regression model showed that coal burning coal burning index (beta =1.973,95%CI:0.126-3.820), dust exposure (beta =2.982,95%CI:0.956-5.009), and smoking (beta =1.557,95%CI:0.374-3.487) were positively correlated with CAT (P0.05), and kitchen ventilation (beta =-2.314,95%CI:-3.546-) -1.081), FEV1% (beta =-0.082,95%CI:-0.144--0.021) and FEV1/FVC (beta =-0.126,95%CI:-0.234--0.081) were negatively correlated with CAT (P0.05).
Conclusion: the index of burning coal and burning coal, dust contact is the environmental risk factor of COPD in Kashi area of Xinjiang, and it has an important influence on the quality of life of patients, especially the relationship between dust exposure and COPD disease, smoking and passive smoking are the risk factors of COPD in the people of Kashi, Xinjiang and the patients. The pulmonary function and the quality of life have an influence. The nutritional status is positively related to the risk of COPD disease, which is a risk factor for the pathogenesis of COPD; the kitchen ventilation is not only a protective factor for the pathogenesis of COPD, but the good ventilation in the kitchen can help to improve the quality of life of the patients.
【學(xué)位授予單位】：復(fù)旦大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R563.9
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