摘要
目的调查上海市金山区社区居住人群COPD的发病特点、诊断和治疗情况,为有效制订更完善的社区COPD防治策略提供依据。方法以问卷调查的形式在金山区11个入选社区人群中进行COPD诊断和治疗情况的调查,调查问卷的设计主要参考圣·乔治呼吸问卷(SGRQ)、COPD评估测试(CAT)和COPD临床问卷(CCQ),并加以简化;记录被调查人群的一般资料、相关暴露因素、呼吸系统疾病史、诊断和具体治疗措施、肺功能等,对确诊为COPD的患者进行病情严重度评估。比较不同性别、年龄、居住环境人群的患病率,以及其诊断和治疗情况。分析COPD患病的危险因素。结果金山区社区人群COPD总体患病率为4.89%(761/15560),其中男性患病率为7.59%(601/7920),高于女性(2.09%,160/7640);40岁及以上人群患病率为8.44%(706/8360),高于40岁以下人群(0.76%,55/7200);男性40岁及以上人群患病率为12.47%(551/4420),高于女性(3.93%,155/3940),两组间的差异均有统计学意义(P值均<0.05)。农村社区现住人口40岁及以上患病率为15.07%(471/3125),高于全区水平(P<0.05)。全区人群中调查前COPD诊断率为12.35%(94/761),其中城镇社区诊断率为32.07%(59/184),高于农村社区(6.06%,35/577),两者间的差异有统计学意义(P<0.05)。城镇、农村社区诊断为COPD的患者中分别有59.32%、57.14%接受了规范化治疗,两者间的差异无统计学意义(P>0.05)。logistic回归分析发现,年龄(OR=1.764,95%CI为1.587~2.128)、吸烟(OR=3.334,95%CI为2.873~4.693)、家庭成员有呼吸系疾病史(OR=6.057,95%CI为3.098~9.535)为区内社区人群COPD发病的相关危险因素(P值均<0.05)。结论金山区实际居住于农村的人口中COPD的发病率高于全区水平。农村社区的COPD诊断率低于城镇,近半数患者未得到规范化治疗,有必要制订更完善的社区COPD防治策略。
Objective To investigate clinical characteristics and current situation of the diagnosis and treatment of chronic obstructive pulmonary disease(COPD)in community residents of Jinshan District in Shanghai,so as to provide a reference for effective community COPD prevention and control strategies.Methods Questionnaire survey was conducted in 11 communities selected from Jinshan District to investigate the diagnosis and treatment of COPD.The design of the questionnaire was mainly based on the simplified St.George respiratory questionnaire(SGRQ),COPD assessment test(CAT)and COPD clinic questionnaire(CCQ).The general data,related exposure factors,history of respiratory diseases,diagnosis and treatment measures,and pulmonary function were recorded.The severity of COPD was evaluated.The prevalence rate,diagnosis and treatment,and risk factors of COPD were analyzed.Results The overall COPD prevalence rate of Jinshan community population was 4.89%(761/15560).The prevalence rate of males was 7.59%(601/7920),which was significantly higher than that of females(2.09%,160/7640,P<0.05).The prevalence rate of people no less than 40 years old was significantly higher than that of people less than 40 years(8.44%[706/8360]vs.0.76%[55/7200],P<0.05).The morbidity of males over 40 years old was significantly higher than that of females no less than 40 years(12.47%[551/4420]vs.3.93%[55/3940],P<0.05).The prevalence rate of rural residents no less than 40 years old was 15.07%(471/3125),which was higher than that of the whole region(P<0.05).The diagnostic rate of COPD in the whole area was 12.35%(94/761)before this survey;the diagnostic rate in urban communities was 32.07%(59/184),which was significantly higher than that in rural communities(6.06%,35/577,P<0.05).Standardized treatment was given to 59.32%and 57.14%of COPD patients in urban and rural communities,respectively(P>0.05).Logistic regression analysis showed that age(OR=1.764,95%CI:1.587-2.128),smoking(OR=3.334,95%CI:2.873-4.693)and family history of respiratory diseases(OR=6.057,
作者
徐丽
许东晴
穆怀典
陆慧珍
钟杉
周敏
XU Li;XU Dongqing;MU Huaidian;LU Huizhen;ZHONG Shan;ZHOU Min(Department of Respiratory Medicine,Jinshan Branch of the Sixth People’s Hospital of Shanghai,Shanghai 201599,China;不详)
出处
《上海医学》
CAS
北大核心
2020年第8期454-458,共5页
Shanghai Medical Journal
基金
上海市金山区科学技术创新资金项目(2015-3-19)
2015年上海市青年医师培养资助计划(沪卫计人事[2015]147号)
第六周期金山区医学重点专科建设项目(JSZK2019A04)。
关键词
肺疾病
慢性阻塞性
社区
调查和问卷
发病特点
诊断和治疗
危险因素
Pulmonary disease,chronic obstructive
Community
Questionnaire survey
Characteristics of disease
Diagnosis and treatment
Risk factors
