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目的通过问卷调查分析慢性阻塞性肺疾病(COPD)患病的危险因素,探讨问卷调查联合肺功能测定在COPD早期诊断中的价值。方法以2014年9月至2015年3月在肥城市人民医院呼吸科行肺功能检查且年龄≥40岁的347例受检者为研究对象,在肺功能测定前对所有受检者同时采用国际初级气道保健组织(IPAG)和国际呼吸道疾病基层医疗组织(IPCRG)设计问卷进行统一调查。并根据肺功能结果分为COPD组和非COPD组,比较两组的一般资料,筛选患COPD的单因素危险因素,采用多因素非条件logistic回归进行分析。结果 347例受检者中COPD检出率为21.6%。问卷总分≥17分共115例,其中COPD患者73例(63.5%),问卷总分<17分共232例,其中COPD患者2例(0.9%),总分≥17分组的COPD检出率明显高于问卷总分<17分组,差异有统计学意义(χ2=177.934,P<0.01)。非COPD组的学历水平、BMI明显高于COPD组,吸烟比例、粉尘接触史明显低于COPD组,差异均有统计学意义(P<0.05)。两组在取暖材料、烹饪材料方面差异均无统计学意义(P>0.05)。多元logistic回归分析显示,男性、高龄、低BMI、吸烟、粉尘接触史和低学历是COPD发生的危险因素(P<0.05)。结论通过问卷调查筛选COPD高危人群联合肺功能测定,有利于无症状的COPD的早期诊断、早期干预。
Objective To investigate the risk factors of chronic obstructive pulmonary disease (COPD) by questionnaire survey and explore the value of questionnaire combined with pulmonary function test in the early diagnosis of COPD. Methods From September 2014 to March 2015 in Feicheng City People’s Hospital Department of Respiratory Breathing lung function tests and 347 subjects aged 40 years of age as the object of study before the lung function test for all subjects while using international Primary Airway Health Organization (IPAG) and International Respiratory Disease Primary Care Organization (IPCRG) Design Questionnaire. According to the results of pulmonary function, the patients were divided into COPD group and non-COPD group. The general data of two groups were compared. The single factor risk factors of COPD were screened and analyzed by multivariate non-conditional logistic regression. Results The detection rate of COPD in 347 subjects was 21.6%. The total score of the questionnaire was ≥17 points in total of 115 cases, of which 73 cases (63.5%) of COPD patients, questionnaire total score <17 points a total of 232 cases, including 2 COPD patients (0.9%), total score ≥ 17 group COPD detection rate Significantly higher than the questionnaire score <17 group, the difference was statistically significant (χ2 = 177.934, P <0.01). The educational level of non-COPD group, BMI was significantly higher than that of COPD group, the smoking proportion, dust exposure history was significantly lower than COPD group, the difference was statistically significant (P <0.05). There was no significant difference in heating materials and cooking materials between the two groups (P> 0.05). Multivariate logistic regression analysis showed that male, advanced age, low BMI, smoking history, dust exposure history and low education were the risk factors of COPD (P <0.05). Conclusions Screening of high risk COPD patients with pulmonary function tests by questionnaire is helpful for the early diagnosis and early intervention of asymptomatic COPD.