【摘要】 目的 探索健康生活方式对慢性阻塞性肺疾病（COPD）发病风险的影响，为COPD预防与干预政策的制定提供科学依据。方法 基于2004—2008年中国慢性病前瞻性研究苏州市吴中区项目点数据，选取其中符合标准的45 484人为研究对象，收集信息包括社会人口学特征、个人或家庭健康状况、室内空气污染情况和生活方式，其中生活方式包括吸烟、饮酒、体力活动、饮食和体型。随访人年数从基线调查开始计算，直至随访出现COPD的发病、死亡或失访，或者至2017年12月31日为止。使用R 4.3.2软件进行χ2检验，采用Cox比例风险回归模型分析生活方式与COPD发病风险的关联强度。结果 截至2017年12月31日，研究对象中位随访时间为11.12年，随访期间共诊断COPD 524人，COPD的发病密度为105.54/10万人年。多因素Cox比例风险回归分析显示，采用多种健康生活方式与COPD的发病风险降低相关，趋势性检验差异有统计学意义（P<0.01）；单项健康生活方式中，不吸烟（HR=0.62,95%CI:0.46～0.84）、高水平体力活动（HR=0.70,95%CI:0.56～0.87）、均衡膳食（HR=0.61,95%CI:0.42～0.88）与COPD的发病风险降低呈正相关（P<0.05）。健康生活方式评分越高，COPD的发病风险越低（HR=0.82,95%CI:0.73～0.92），与至多具备1种健康生活方式相比，具备至少4种健康生活方式的研究对象，COPD发病风险降低了43%(HR=0.57,95%CI:0.40～0.83)。结论 健康生活方式与较低的COPD发病风险有关，遵循健康的生活方式可以降低成年人COPD发病风险。更多还原

【Abstract】 Objective To explore the impact of healthy lifestyle on the risk of developing chronic obstructive pulmonary disease(COPD),and provide a scientific basis for the prevetion and intervention policies for COPD. Methods The data were obtained from the baseline and follow-up information of 45 484 respondents aged 30-79 years old from the China Kadoorie Biobank project in Wuzhong District,Suzhou,from 2004 to 2008. Information collected included socio-demographic characteristics,personal or family health status,indoor air pollution status,and lifestyle. Lifestyle included smoking,alcohol consumption,physical activity,diet,and body mass index. Person-years followed up were calculated from the baseline survey until COPD onset,death,loss to follow-up at follow-up or until December 31,2017. The χ2test was used to analyze the data. The association between lifestyle and the risk of COPD was analyzed using the Cox proportional risk regression model by R 4.3.2 software. Results As of December31,2017,the median follow-up time of the study population was 11.12 years,and 524 people were diagnosed with COPD during the follow-up period,with an incidence density of COPD of 105.54/100 000 person-years. Multifactorial Cox proportional risk regression analysis showed that the adoption of multiple healthy lifestyles was associated with a reduced risk of developing COPD,and the difference was statistically significant in the test for trend(P<0.01);among the separate healthy lifestyles,nonsmoking(HR=0.62,95%CI:0.46-0.84),high level physical activive(HR=0.70,95%CI:0.56-0.87),and healthy dietary habits(HR=0.61,95%CI :0.42-0.88)were associated with a reduced risk of developing COPD(P<0.05). Higher healthy lifestyle scores were associated with a lower risk of COPD(HR=0.82,95%CI:0.73-0.92),and study participants with at least 4 healthy lifestyles had a43% lower risk of developing COPD compared with those with at most 1 healthy lifestyle(HR =0.57,95% CI:0.40-0.83).Conclusion Healthy lifestyle is associated with lower risk of developing COPD,and following a healthy lifestyle reduces the risk of COPD in adults.更多还原