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南京市≥40岁居民慢性阻塞性肺疾病的知晓、治疗和控制情况及影响因素分析

Status and determinants of chronic obstructive pulmonary disease awareness, treatment, and control among residents aged 40 years and older in Nanjing city: a cross-sectional study

  • 摘要:
    目的 了解江苏省南京市≥40岁居民慢性阻塞性肺疾病(COPD)的知晓率、治疗率和控制率及影响因素,为COPD的人群防控策略的制定提供参考依据。
    方法 于2023年5月—2024年1月,采用多阶段整群随机抽样方法,在南京市抽取2 442名≥40岁常住居民进行问卷调查和肺功能检测;采用χ2检验比较不同社会人口学特征人群COPD知晓率、治疗率和控制率差异,采用2020年江苏省人口普查数据进行率的标化,使用多因素 logistic 回归模型分析其影响因素。
    结果 在2 442名研究对象中,共筛查出COPD患者262例,患病率为10.73%(标化率为11.39%)。在262例COPD患者中,患病知晓率为6.87%,治疗率为4.20%,控制率为3.05%,标化率分别为7.24%、4.41%和2.60%。多因素logistic回归分析结果显示,有慢性呼吸道症状(OR=4.91,95%CI=1.59~15.15)、有COPD家族史者(OR=18.51,95%CI=1.68~203.89)和戒烟者(OR=9.14,95%CI=2.52~33.15)的COPD知晓率较高;有慢性呼吸道症状者(OR=11.59,95%CI=2.76~48.72)的COPD治疗率较高;有慢性呼吸道症状者(OR=8.66,95%CI=1.99~37.65)的控制率较高。
    结论 南京地区≥40岁居民的COPD患病率较高,但患者的COPD知晓率、治疗率和控制率均较低;慢性呼吸道症状、慢性阻塞性肺疾病家族史和吸烟情况是该地区居民COPD知晓、治疗和控制情况的主要影响因素;应采取综合措施提高COPD的诊断、干预与管理水平。

     

    Abstract:
    Objective To investigate the awareness, treatment, and control rates of chronic obstructive pulmonary disease (COPD) and their influencing factors among residents aged 40 years and older in Nanjing city to provide a reference for the development of COPD prevention and control strategies in the population.
    Methods A total of 2 442 permanent residents aged 40 years and older were recruited from urban communities and rural villages in four districts of Nanjing city, Jiangsu province, using a multistage cluster random sampling method. Face-to-face interviews were conducted using the China Chronic Disease and Nutrition Surveillance Questionnaire, and pulmonary function tests were performed from May 2023 to January 2024. The chi-squared test was used to compare differences in COPD awareness, treatment, and control rates, standardized by the 2020 Jiangsu Provincial Census data, across participant characteristics. Factors influencing these rates were analyzed using multivariable logistic regression models.
    Results Of all participants, 262 (10.73%) were diagnosed with COPD, with a standardized prevalence rate of 11.39%. Of the 262 identified COPD patients, 6.87%, 4.20%, and 3.05% reported awareness, treatment, and control of the disease, with standardized rates of 7.24%, 4.41%, and 2.60%, respectively. Multivariable logistic regression revealed that chronic respiratory symptoms (odds ratio OR=4.91, 95% confidence interval 95%CI: 1.59-15.15), family history of COPD (OR=18.51, 95%CI: 1.68-203.89), and smoking cessation (OR=9.14, 95%CI: 2.52-33.15) were associated with increased odds of COPD awareness. In addition, chronic respiratory symptoms were associated with increased odds of treatment (OR=11.59, 95%CI: 2.76-48.72) and COPD control (OR=8.66, 95%CI: 1.99-37.65).
    Conclusions The prevalence of COPD among residents aged 40 and older in Nanjing is relatively high. However, the awareness, treatment, and control rates of COPD among affected residents remain low. Chronic respiratory symptoms, family history of COPD, and smoking status are the main factors influencing COPD awareness, treatment, and control in this population. Comprehensive measures should be implemented to improve the diagnosis, intervention and management of COPD.

     

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