Epidemic Situation And Risk Factors Analysis Of COPD In Partial Areas Of Hunan Province

Objective(1) To survey the prevalence of chronic obstructive pulmonary disease(COPD) in partial areas of Hunan province and relevant risk factors.(2) To provide a basis of the prevention and treatment for COPD.Methods Using the same protocol of the Burden of Obstructive Lung Disease(BOLD) study,a questionnaire survey was conducted among 8269 respondents,including 4248 urban residents and 4021 rural residents,aged over 15,by a simple cluster random sampling method in Changsha,Hunan,Wulipai street North Station community and Yang Jia Zhou,Dong Jing,Lian Tan three villages of Wang Ling town.(1) All the respondents filled out a unified epidemiological survey questionnaire.(2) All of the respondents received examination for lung function and lung function indices(FEV₁/FVC＜70%),which are regarded as gold criteria of diagnosis of COPD.The diagnosis of COPD was made by the gold standard,combining with a history of respiratory tract disease.(3) Those respondents showed FEV1/FVC＜70%were further examined by ECG,X ray inspection for differential diagnosis.(4) The data of epidemiological survey was analyzed by multivariate Logistic regression method. Results(1) A total of 8269 residents were surveyed but there were 8243 cases with full data and good quality spirometry test,including 4240 urban respondents and 4003 rural respondents,4026 male and 4217 female.The total prevalence of COPD was 5.06%(95%CI为0.76～9.36).(2) The prevalence of COPD in the males was 7.6%,and 2.6%in the females.The prevalence of COPD in the males was significantly higher than that in the females(χ²=107.936 P=0.000).(3) The prevalence of COPD in the rural area was 5.3%and 4.8%in the urban,but the difference was not statistically significant.The standardized prevalence in the rural area was 11.99%,significantly higher than that in the urban area(8.7%),and the differences were significance(P＜0.01).(4) Grouping by every 10 years of age,the differences of the prevalence of COPD among the age groups were significance,both in males and in females,in urban areas and in rural areas.The prevalence increased with age increasing.The prevalence of COPD was significantly higher in 45-year-old and over groups.(5) The prevalence of COPD was different among different levels of education(P＜0.01,the more the education was,the lower prevalence was.(6) Those respondents who has a family history of COPD have a higher prevalence of COPD than that of without a family history of COPD(P＜0.05). (7) Regardless of urban and rural areas,the prevalence of COPD of smokers was higher than that of non-smokers.The greater the smoking index was,the higher the prevalence of COPD was.The prevalence of COPD in the people of passive smoking was higher than that in those who do not second-hand smoke,and the difference was statistically significant.(8) Risk factors analysised with one-way non-conditional logistic regression are as follow:The housing toward,lighting and ventilation are not found to be risk factors of COPD in rural,while they are found to be risk factors of COPD in urban.Using coal and firewood in cooking and occupational inhalation of dust are different in rural with urban.The rest risk factors of cooking,smoking,smoking index,passive smoking, sex,age,family history and education degree are consistent.The education degree is protective factor in rural and urban.Conclusions The prevalence of COPD in the partial rural area was higher than that in the partial urban area.The prevalence in males was higher than that in females.The prevalence of COPD increased with age increasing.The risk factor of COPD in urban have the housing toward, lighting,ventilation,pet feeding,cooking,age,sex,smoking,passive smoking,smoking intensity,and family history.While the risk factor of COPD in rural have cooking,age,sex,smoking,passive smoking, smoking intensity,family history,occupational inhalation of dust,coal and firewood fuels.The education degree is protective factor in rural and urban.