论文部分内容阅读
目的:调查乡镇社区居民肺功能改变情况及其影响因素，并探讨其防控措施。方法:2017年9月至2019年12月对青岛市某乡镇社区接受公共卫生服务的居民进行调查，采集受试者人口学、行为学及病史信息，采用简易肺功能仪测定用力肺活量（FVC）、一秒用力呼气容积（FEVn 1）；采用单因素和多因素分析其影响因素。n 结果:共调查5 184例，男性2 199例（42.4%），女性2 985例（57.6%）。肺功能不达标者1 322例，占25.5%。单因素分析发现，年龄 ≥ 60岁居民发生肺功能不达标的风险明显高于 < 60岁者（26.1%比14.3%，χ n 2=19.34，n P < 0.001），且男性高于女性（32.9%比20.0%，χ n 2=110.74，n P < 0.001）。随着体质量的增加，肺功能下降的发生率逐渐降低，体质量过轻者的肺功能不达标率（43.4%）高于体质量正常者（27.8%）和超重者（22.8%）（χ n 2=8.86、17.63，n P=0.003、< 0.001）。既往有慢性支气管炎、支气管哮喘或阻塞性肺疾病病史的患者肺功能不达标率显著高于无该类病史的居民（68.3%比23.2%，χn 2=263.33，n P < 0.001）。有吸烟史者无论是否已戒烟，其肺功能未达标率明显高于不吸烟者（35.1%、36.3%比22.8%，χ n 2=48.83、86.46，均n P < 0.001）。而肺功能达标率与粉尘化学毒物接触史、呼吸系统疾病家族史均无关（χ n 2=0.38、2.29，n P=0.535、0.130）。多因素分析显示，60岁及以上、男性、体质量过轻、吸烟和有呼吸系统既往病史是肺功能不达标的独立危险因素。在吸烟人群中，肺功能不达标者的吸烟量比肺功能达标者高（n t=-2.39，n P=0.009）。n 结论:肺功能不达标有较多危险因素，基层医疗机构应当开展肺功能检测并有针对性地制定预防策略，从而实现慢性阻塞性肺疾病的早发现、早治疗。“,”Objective:To observe the changes of pulmonary function and its influential factors in residents of a rural community and investigate the prevention and control measures.Methods:A survey was made in residents from a rural community in Qingdao who received public health services from September 2017 to December 2019. The demographic data, behavioral and medical history information were collected. Forced vital capacity and forced expiratory volume in one second were measured. The factors that affect lung function were analyzed using univariate analysis and multivariate analysis.Results:This survey involved 5184 residents consisting of 2199 (42.4%) males and 2985 (57.6%) females. 1322 (25.5%) residents had pulmonary dysfunction. Univariate analysis showed that residents aged ≥ 60 years had a higher risk for developing pulmonary dysfunction than residents aged < 60 years (26.1% n vs. 14.3%, n χ2 = 19.34, n P < 0.001), and male residents had a higher risk for developing pulmonary dysfunction than female residents (32.9% n vs. 20.0%, n χ2 = 110.74, n P < 0.001). With the increase in body mass, the incidence of pulmonary dysfunction gradually decreased. The proportion of residents with pulmonary dysfunction with low body mass was higher than that in residents with normal body mass and high body mass (43.4% n vs. 27.8% or 22.8%, n χ2 = 8.86, 17.63, n P = 0.003, < 0.001). The proportion of residents with pulmonary dysfunction was higher in those with a history of chronic bronchitis, bronchial asthma, or obstructive pulmonary disease than in those without such a history (68.3% n vs. 23.2%) n χ2 = 263.33, n P < 0.001). The proportion of residents with pulmonary dysfunction was significantly higher in smokers, whether or not had quit smoking than in non-smokers (35.1%, 36.3% n vs. 22.8%, n χ2 = 48.83, 86.46, both n P < 0.001). The proportion of residents with the normal pulmonary function was not related to the exposure history of dust and chemical poisons and the family history of respiratory diseases ( n χ2 = 0.38, 2.29, n P = 0.535, 0.130). Multivariate analysis showed that age ≥ 60 years, male sex, low body mass, smoking, and a history of respiratory system diseases were the independent risk factors for pulmonary dysfunction. Among smokers, the number of cigarettes smoked was higher in smokers with pulmonary dysfunction than those with normal pulmonary function (n t = -2.39, n P = 0.009).n Conclusion:There are many risk factors for pulmonary dysfunction. Primary medical service institutes should carry out pulmonary function testing and formulate targeted prevention strategies, which help realize early detection and treatment of chronic obstructive pulmonary disease.