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目的 研究慢性支气管炎患者慢性阻塞性肺疾病 (COPD)发病的影响因素。方法 1992年对≥ 15岁的 6 72 5 1名农民普查发现 1999例未发生COPD的慢性支气管炎患者 ,收集吸烟、COPD家族史、炉灶情况、粉尘接触、肺功能等基线资料。整群随机分为干预区和对照区 ,对干预区实施戒烟宣传等干预措施。 2 0 0 0年采用分层随机抽样方法抽取 1114例进行复查。结果 应答且资料完整者 86 9例 (占 1114例的 78 0 %)。吸烟、基线COPD家族史阳性使第 1秒用力呼气量 (FEV1)和 /或第 1秒用力呼气量百分比 (FEV1/FVC)随年龄下降速度加快 ,戒烟者与不吸烟者下降速度无显著差异。COPD 8年累积发病与基线年龄、吸烟、COPD家族史阳性呈独立的正相关 ,而与基线FEV1和FEV1/FVC呈独立的负相关。戒烟与不吸烟者发病危险差异无显著意义。结论 衰老、吸烟、COPD家族史、肺功能低下是慢性支气管炎患者COPD发病独立的危险因素 ,性别不是独立的危险因素 ,戒烟可使吸烟者发病危险降低至近似于不吸烟者的水平。
Objective To study the influencing factors of the pathogenesis of chronic obstructive pulmonary disease (COPD) in patients with chronic bronchitis. Methods A total of 672 5 peasants aged ≥ 15 years old were enrolled in this survey. In 1999, a total of 1999 chronic bronchitis patients without COPD were collected to collect baseline data such as smoking, family history of COPD, stove condition, dust exposure and lung function. The whole group was randomly divided into intervention area and control area, and implemented interventions such as smoking cessation and publicity on the intervention area. In 2004, stratified random sampling method was used to select 1114 cases for review. 869 cases (78 0% of 1114 cases) responded with complete information. Smoking, positive baseline COPD family history of forced expiratory volume of 1 second (FEV1) and / or 1 second forced expiratory volume (FEV1 / FVC) with age decline accelerated, quit smoking and non-smoker did not decline significantly difference. The 8-year cumulative incidence of COPD was independently and positively correlated with baseline age, smoking, positive COPD family history, and negatively correlated with baseline FEV1 and FEV1 / FVC. No significant difference was found between the risk of quitting smoking and non-smoker. Conclusion Aging, smoking, family history of COPD, and hypogastric dysfunction are independent risk factors for COPD in patients with chronic bronchitis. Gender is not an independent risk factor. Quitting smoking can reduce the risk of smoker to approximately the level of non-smoker.