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湖北省监测地区 ≥ 40岁居民2014年与2019年慢性阻塞性肺疾病流行病学特征比较

Variation in prevalence and impact factors of chronic obstructive pulmonary disease among residents aged over 40 years in disease surveillance sites of Hubei province between 2014 and 2019: a comparison analysis

    摘要
  • 摘要:
      目的  比较2014年和2019年湖北省监测地区 ≥ 40岁居民慢性阻塞性肺疾病（COPD）流行病学特征，为COPD的预防控制提供参考依据。
      方法  分别于2014年12月 — 2015年3月和2019年11月 — 2020年12月采用多阶段随机抽样方法在湖北省应城市、公安县、嘉鱼县和随县4个监测地区各抽取2400名 ≥ 40岁居民进行问卷调查和肺功能检查。
      结果  湖北省监测地区2014年和2019年最终纳入分析的2389和2396名 ≥ 40岁居民中，患COPD者分别为213和272例，经复杂加权后COPD患病率分别为12.36%和11.95%；在COPD患者中，气流受限严重程度为轻度者所占比例从2014年的71.83%下降到2019年的52.94%，气流受限严重程度为中度者所占比例从2014年的22.07%上升到2019年的38.97%，差异均有统计学意义（均P < 0.001）；湖北省不同年份监测地区 ≥ 40岁居民COPD相关因素比较，戒烟率从2014年的18.92%上升到2019年的23.11%（χ2 = 4.164，P = 0.041），职业粉尘和/或有害气体防护率从2014年的18.53%上升到2019年的54.69%（χ2 = 14.321，P < 0.001），家庭取暖煤燃料使用率从2014年的2.43%下降到2019年的0.38%（χ2 = 19.035，P < 0.001），儿童期严重呼吸道感染率从2014年的3.01%下降到2019年的1.30%（χ2 = 15.861，P < 0.001），呼吸困难流行率从2014年的8.14%下降到2019年的3.81%（χ2 = 4.767，P = 0.029）。
      结论  2014年和2019年湖北省监测地区 ≥ 40岁居民COPD患病率无明显变化，部分COPD相关因素的流行趋势有明显改善，但仍需持续加强COPD的监测和防治工作。

     

    Abstract:
      Objective  To compare the prevalence and influencing factors of chronic obstructive pulmonary disease (COPD) among residents aged over 40 years in disease surveillance sites of Hubei province in 2014 and 2019 for providing evidence to COPD prevention and control.
      Methods  Two waves of survey, including face-to-face questionnaire interview and pulmonary function test, were conducted among 2 400 adults ( ≥ 40 years old) recruited in 4 disease surveillance sites in Hubei province using stratified multistage cluster sampling during December 2014 – March 2015 and November 2019 – December 2020. The modified Medical Research Council (mMRC) dyspnea scale and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage were adopted in the study.
      Results  Among the 2 389 participants in 2014 – 2015 survey and 2 396 in 2019 – 2020, 213 and 272 COPD patients were identified, with the prevalence rate of 12.36% and 11.95% estimated through complex weighting, respectively. Compared to those in the survey of 2014 – 2015, the proportion of the COPD patients at GOLD stage I decreased (52.94% vs. 71.83%) but that of at GOLD stage II increased (38.97% vs. 22.07%) significantly in the survey of 2019 – 2020 (both P < 0.001). In terms of exposure to COPD-related factors among the participants in the survey of 2019 – 2020 and in comparison with those in the survey of 2014 – 2015, the smoking cessation rate increased from 18.92% to 23.11% (χ2 = 4.164, P = 0.041); the rate of taking protective measures against occupational dust or hazardous gas increased from 18.53% to 54.69% (χ2 = 14.321, P < 0.001); the percentage of using coal for heating decreased from 2.43% to 0.38% (χ2 = 19.035, P＜0.001); the proportion of having the history of childhood severe respiratory infection decreased from 3.01% to 1.30% (χ2 = 15.861, P < 0.001); and the detection rate of dyspnea decreased from 8.14% to 3.81% (χ2 = 4.767, P = 0.029).
      Conclusion  No significant change was observed in the prevalence of COPD between 2014 and 2019 among the residents aged ≥ 40 years in surveillance sites of Hubei province but the prevalence of exposure to some COPD-related factors decreased significantly.

     

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