CAJ | 학술논문

目的探究慢性阻塞性肺疾病(COPD)是否具有家族聚集性.方法 2002-2004年我国7省市(北京市、上海市、广东省、辽宁省、天津市、重庆市和陕西省)的横断面调查研究,采用多阶段整群随机抽样方法,对≥40岁的人群进行问卷调查(包括COPD可能相关的危险因素等)和肺功能检测[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)].父母或兄弟姐妹之一患有慢性支气管炎、肺气肿、支气管哮喘或COPD之一者被认为有COPD相关疾病家族史.结果有COPD相关疾病家族史者FEV1为(2.24 ±0.70)L,无COPD相关疾病家族史者FEV1为(2.28 ±0.72)L,两者比较差异有统计学意义(F=10.997,P=0.001).有COPD相关疾病家族史者COPD患病率为12.1％ (540/4 481),无COPD相关疾病家族史者为7.2％(1 128/15 764),两者比较差异有统计学意义(r=110.599,P＜0.001).多因素logistic回归分析显示,有COPD相关疾病家族史者COPD患病相对危险度(OR)为2.18(95％ CI 1.94 ～2.46),且家族中有2人或2人以上患COPD相关疾病者,其患COPD的OR为2.48(95％ CI2.00～3.08),大于家族中只有1人患COPD相关疾病者(OR =2.10,95％ CI1.84 ～2.40).父亲、母亲和兄弟姐妹患COPD相关疾病者患COPD的风险接近(OR=1.54,95％ CI1.32～1.80;OR=1.83,95％CI 1.56 ～2.15;OR=1.81,95％ CI 1.48～2.23).结论 COPD患病具有家族聚集性,且家族中患COPD相关疾病者越多,患COPD的风险越高.
목적 탐구만성조새성폐질병(COPD)시부구유가족취집성.방법 2002-2004년아국7성시(북경시、상해시、광동성、요녕성、천진시、중경시화합서성)적횡단면조사연구,채용다계단정군수궤추양방법,대≥40세적인군진행문권조사(포괄COPD가능상관적위험인소등)화폐공능검측[제1초용력호기용적(FEV1)、용력폐활량(FVC)].부모혹형제저매지일환유만성지기관염、폐기종、지기관효천혹COPD지일자피인위유COPD상관질병가족사.결과 유COPD상관질병가족사자FEV1위(2.24 ±0.70)L,무COPD상관질병가족사자FEV1위(2.28 ±0.72)L,량자비교차이유통계학의의(F=10.997,P=0.001).유COPD상관질병가족사자COPD환병솔위12.1％ (540/4 481),무COPD상관질병가족사자위7.2％(1 128/15 764),량자비교차이유통계학의의(r=110.599,P＜0.001).다인소logistic회귀분석현시,유COPD상관질병가족사자COPD환병상대위험도(OR)위2.18(95％ CI 1.94 ～2.46),차가족중유2인혹2인이상환COPD상관질병자,기환COPD적OR위2.48(95％ CI2.00～3.08),대우가족중지유1인환COPD상관질병자(OR =2.10,95％ CI1.84 ～2.40).부친、모친화형제저매환COPD상관질병자환COPD적풍험접근(OR=1.54,95％ CI1.32～1.80;OR=1.83,95％CI 1.56 ～2.15;OR=1.81,95％ CI 1.48～2.23).결론 COPD환병구유가족취집성,차가족중환COPD상관질병자월다,환COPD적풍험월고.
Objective To investigate the familial aggregation in chronic obstructive pulmonary disease (COPD).Methods Based on a cross-sectional survey in seven provinces/cities in China (Beijing,Shanghai,Guangdong,Liaoning,Tianjin,Chongqing and Shaanxi) from 2002 to 2004,the familial aggregation of COPD was investigated with multi-stage cluster random sampling method.One urban and one rural area were selected as samples from each of seven provinces/cities.All residents equal or older than 40 years old received questionnaires and pulmonary function tests.Questionnaires included risk factors of COPD,respiratory symptoms,quality of life,diagnosis and prevention conditions of COPD.Bronchodilator tests,physical examination,X-ray and electrocardiograph (ECG) were conducted in those subjects.In pulmonary function tests,the ratio of the first second forced expiratory volume (FEV1) /forced vital capacity (FVC) less than 70％ fulfill the diagnostic criteria of COPD.If any of siblings and parents had chronic bronchitis,emphysema,asthma or COPD,it should be considered as a positive family history of COPD-related disease.Otherwise,it was negative.Results FEV1 was lower in the subjects with a family history of COPDrelated diseases than in those without [(2.24 ±0.70) L vs (2.28 ±0.73) L].The prevalence of COPD in the population with history of COPD-related diseases was 12.1％ (540/4 481),which was significantly higher than that without [7.2％ (1 128/15 764),x2 =110.599,P ＜ 0.001].After adjusted for potential confounder,the population with a family history of COPD-related diseases still had much higher incidence of COPD [OR =2.18 (95％ CI 1.94-2.46)].Furthermore,the population having two or more first-degree relatives with COPD-related diseases,exhibited the highest likelihood of COPD [OR =2.48 (95％ CI 2.00-3.08)].The population having only one first-degree relative with COPD-related diseases showed an increased risk of COPD with an OR =2.10 (95％ CI 1.84-2.40) compared with those without any one.Those whose father,mother or siblings had COPD-related diseases were similarly likely to have COPD,with an OR of 1.54 (95％ CI 1.32-1.80),1.83 (95％ CI 1.56-2.15) and 1.81 (95％ CI 1.48-2.23),respectively.Conclusions There is a familial aggregation in COPD.The more relatives have COPD-related diseases in the family,the greater risk of COPD the subject will have.