【摘要】 目的 了解贵州省≥40岁农村居民慢性阻塞性肺疾病（COPD）的流行现状及影响因素，为完善COPD防控策略提供科学依据。方法 于2019—2020年采用多阶段分层随机抽样方法抽取贵州省8个县（市、区）4 003名≥40岁农村居民进行问卷调查、体格检查和肺功能检查。数据分析使用R 4.2.3软件，采用weighted.mean函数计算复杂抽样加权分析的COPD患病率，χ~2检验及多因素logistic回归的复杂抽样加权分析分别采用survey包及RDS包。结果 4 003名农村居民中COPD患者371人，加权患病率为9.82%，男性COPD加权患病率（12.87%）高于女性（6.79%），差异有统计学意义（P<0.01）。多因素logistic回归分析结果显示，50～岁（OR=1.974,95%CI:1.178～3.309）、60～岁（OR=2.592,95%CI:1.513～4.442）、70～岁（OR=3.458,95%CI:1.852～6.460）,18岁前肺部感染史（OR=2.092,95%CI:1.095～3.999），哮喘（OR=3.380,95%CI:1.758～6.498），吸烟（OR=1.968,95%CI:1.110～3.487），有害气体暴露（OR=1.537,95%CI:1.117～2.116），消瘦（OR=2.472,95%CI:1.164～5.248）与男性农村居民COPD患病高风险相关；60～岁（OR=5.036,95%CI:2.316～10.950）、70～岁（OR=8.392,95%CI:3.804～18.518）,18岁前肺部感染史（OR=3.884,95%CI:1.652～9.135），哮喘（OR=3.072,95%CI:1.229～7.680），烹饪使用污染燃料和（或）不排风（OR=2.692,95%CI:1.473～4.920）与女性农村居民COPD患病高风险相关（P<0.05,P<0.01）。结论 贵州省农村居民COPD患病处于较高水平，影响因素存在性别差异，应特别关注吸烟、有害气体暴露对男性的影响以及和烹饪时使用污染燃料且不排风对女性的影响。更多还原

【Abstract】 Objective To understand the epidemic status and influencing factors of chronic obstructive pulmonary disease(COPD)among rural residents （≥40 years old） in Guizhou Province,and provide the scientific basis for improving the prevention and control strategies of COPD. Methods From 2019 to 2020,the multi-stage stratified random sampling was used to select 4 003 rural residents （≥40 years old） from eight counties(cities,districts) in Guizhou Province as the subjects. The investigation was performed with the questionnaire,physical examination,and lung function examination. The data analysis was conducted using software R 4.2.3,and the weighted.mean function was used to calculate the morbidity of COPD of complex sampling weighted analysis. The survey package and RDS package were used for complex sampling weighted analysis using χ~2test and multiple logistic regression,respectively. Results Among the 4 003 rural residents,371 cases were COPD patients,the weighted morbidity was 9.82%;the weighted morbidity(12.87%) of COPD in males was significantly higher than that(6.79%) in females,P<0.01. The results of the multivariate logistic regression analysis showed that 50-years old(OR=1.974,95%CI:1.178-3.309),60-years old(OR=2.592,95%CI:1.513-4.442),70-years old(OR=3.458,95%CI:1.852-6.460),history of pulmonary infection before 18years old(OR=2.092,95%CI:1.095-3.999),asthma(OR=3.380,95%CI:1.758-6.498),smoking(OR=1.968,95%CI:1.110-3.487),hazardous gas exposure(OR=1.537,95%CI:1.117-2.116),thin-weight(OR=2.472,95%CI:1.164-5.248) were related to the high risk of COPD in male rural residents;60-years old(OR=5.036,95%CI:2.316-10.950),70-years of age(OR=8.392,95%CI:3.804-18.518),history of pulmonary infection before 18 years old(OR=3.884,95%CI:1.652-9.135),asthma(OR=3.072,95%CI:1.229-7.680),cooking with polluting fuels and(or) no exhaust(OR=2.692,95%CI:1.473-4.920) were related to the high risk of COPD in female rural residents(P<0.05 or P<0.01). Conclusion The prevalence of COPD in rural residents of Guizhou Province is at a high level,and there are gender differences in influencing factors. Special attention should be paid to males with smoking,and exposed to harmful gases,and to females using contaminated fuels for cooking without ventilation.更多还原