| Chronic Obstructive Pulmonary Disease is a chronic bronchus and lung disease featured with airflow obstruction. It develops slowly and progressively, but actutely breaks repeatedly, which seriously affects the life quality and labor of patients. According to the record of WHO, COPD is the fourth mortality. The disease rate and death rate has been increased gradually. It is predicted that it will become the 3rd of the death cause while takes as the 5th huge economic burden in 2020. In the large-sized city, such as Guangzhou, respiratory disorder, COPD as the major, is the forth mortality of residents. In 2009, 8.2% of residents aged 40 and above got the COPD, which is higher than 7.4% of 2005. The disease rate of male, 13.8% is higher than that of female, which is 3.0%.(Chronic Obstructive lung disease epidemiological investigation and analysis in some district of Guangzhou)Due to high rate of the COPD and heavy economic burden, it becomes a serious public hygiene problem.It still remains unclear that the ontogenesis of COPD until now. Inflammatory response, the unbalance of the protease and antiprotease, the unbalance between oxidation and oxidation residents and the disorder of autonomic nerve system, such as abnormal distribution of cholinergic neuroceptor all play important role. The study links that the continuing inflatation reaction of lung and air flue caused by environment factors is the key to COPD. Smoking, long term occupational exposure to the dust and chemical substances cause air flue reaction; provoke tunica mucosa bronchiorum and cause cytotoxicity, which all boost COPD. The COPD epidemiological investigation has always focused on the relationship between environmental factors and the cause of COPD. Despite it is familiar with some of the cause, with the environmental and life style changes caused by the modern industrial development, some of disease causes change accordingly. It is pointed out that it is meaningful to make new research on the pathogen of COPD to prevent and control of COPD in such new era. Besides, gender and age are highly related to the outbreak of the COPD, but the previous research ignored the difference of demography composition, which generate hybrid effect. In this study, it is to make case-control study in some hospitals and communities in Guangzhou, investigate the key risk factors to COPD for residentss in Guangzhou, and analysis the relationship between those risk factors, COPD and pulmonary function.Objective:To investigate the risk factors of COPD for residents in Guangzhou ,to explain the relationship between environmental risk factors, COPD and determination of pulmonary function, to provide clues for pathogen research of COPD and to provide scientific basis for making policy for prevention and treatment for COPD.Methods:Based on case-control study method, it studies several COPD cases in hospitals and communities in Guangzhou during 2008 to 2010. Based on agreement with the respondents, they filled the fixed questionnaire and took pulmonary function test. They were diagnosed COPD by professional doctors, based on FEVI/FVC<70%reference standard.With Inputing all data about questionnaire and test to Excel, It is to filter the risk factors of COPD for southern residents in recent years by processing single-factor and multifactor logistic regression analysis by stata soft. It is to compare the research to the previous cross-sectional study result.Result:1.It has collected 403 complete and qualified pulmonary function test COPD cases. It is filtered 511 healthy cases based on the same gender and age. It indicts that there is no apparent difference in gender, age and ancestral home(P>0.05). the mean value and standard deviation for series isFEV1(1.79±0.03),FVC(2.84±0.04 ) respectively, while the control group is FEV1(2.52±0.61),FVC(3.10±0.03 respectively)(unit L), P was less than 0,0012. In the single-factor analysis,11 exposed factors were found to be associated with COPD, including BMI, education, smoke, second-hand smoke, occupational exposure to dust, arsenic, asbestos, ventilator, coal burning, liquefied petroleum gas burning or gas and biofuel.By successive entry and successive sweep multivariate logistic regression analysis to the cause of COPD, four risk factors and one protective factor were ascertained, there were smoking (OR=2.37, 95%CI=1.78±3.16,P<0.001), biofuel (OR=2.25, 95%CI=1.45±3.49,P<0.001), Occupational exposure to arsenic (OR=4.60 95%CI =1.44±14.6,P=0.010), Occupational exposure to dust(OR=1.63, 95%CI= 1.09±2.43,P=0.016).One protective factor was: high-education (OR=0.72, 95%CI = 0.57±0.91,P=0.006).3.By chromatographic analysis to the five factors between cases to the control group, the FEV1/FVC ratio of subunit of the series is lower than the control group(P<0.001)4. By further study the relationship between smoke and the FEV1/FVC ratio, the FEV1/FVC ratio of smokers in control group is distinctly lower than non-smoker(0.80±0.04 vs 0.82±0.01,P=0.0005). It is meaningless for the difference according to statistics.(0.64±0.01 vs 0.63±0.01,P=0.01780). It is found there is negative growth between FEV1/FVC ratio and the years of smoking(Pearson related coefficient -0.1833,P=0.0296),the amount(Pearson related coefficient -0.2063,P=0.0141)in the control group. In series, there is mere negative growth between FEV1/FVC ratio and the amount(Pearson related coefficient -0.1596,P= 0.0344).Moreover, it is found that FEV1/FVC ratio is related to smoke amount per day in both groups.5. In terms of the relation between the other four factors and FEV1/FVC ratio, it is found those who used biofuel is much lower than those do not use in series(0.60±0.10 vs 0.64±0.10,P=0.0002),while the high school and above is significantly high than illiterate (0.65±0.10 vs 0.61±0.13,P=0.0002)。Conclusion:The result indicates that the same as previous study, the smoking, biofuel , occupational exposure to dust, arsenic are the key risk factors to COPD for residents in Guangzhou, among which the factor of arsenic is the first time to exposed . The high educated can decrease the risk of COPD. For common people, the more they smoke ,the longer they smoke, the FEV1/FVC ratio of pulmonary function is lower . To certain degree, the use of biofuel and the standard of culture affect the pulmonary function. Based on the conclusion, the outbreak of COPD is highly associated with environmental factors. It is suggested to control the environmental risk factors to prevent COPD. |
PDF Full Text Request