CAJ | 학술논문

目的探索北京市城区居民第一秒用力呼气容积(FEV1)下降速度的危险因素.方法在北京市中心3个社区招募40岁以上志愿者共452例,平均年龄(58.8±8.6)岁,其中男131例(29％),女321例(71％).通过问卷调查获得一般情况、既往病史、吸烟史、生活环境情况等.并对受试者先后行2次肺功能检查,测定FEV1及6秒用力呼气容积(FEV6),对FEV1/FEV6＜ 70％的受试者行支气管舒张试验.第一次调查约2年后,随诊复查上述问卷及肺功能检查.结果完成2次调查及肺功能的受试者总FEV1年下降量平均值为(43 ± 114) ml(95％ CI:33 ～54 ml).吸烟者与不吸烟相比,FEV1年下降量分别为(64±125)和(36±109) ml,而戒烟对FEV1下降速度无明显影响.肺功能检查发现慢阻肺及气道高反应性者,其FEV1下降速度快于肺功能正常人群,但差异无统计学意义.另外,慢性咳嗽病史、糖尿病、冠状动脉性心脏病、高血压等病史的人群FEV1下降速度均高于无上述病史者,但差异无统计学意义.在FEV1快速下降组(△FEV1 ≥30 ml/y)与非快速下降组(△FEV1＜30 ml/y)间,进行二元logistic回归分析上述因素后发现,吸烟为FEV1下降加速的独立危险因素.结论北京市中心部分社区居民的FEV1在2年多时间内平均下降速度为(43±114) ml/y,吸烟是FEV1快速下降的独立危险因素.
목적 탐색북경시성구거민제일초용력호기용적(FEV1)하강속도적위험인소.방법 재북경시중심3개사구초모40세이상지원자공452례,평균년령(58.8±8.6)세,기중남131례(29％),녀321례(71％).통과문권조사획득일반정황、기왕병사、흡연사、생활배경정황등.병대수시자선후행2차폐공능검사,측정FEV1급6초용력호기용적(FEV6),대FEV1/FEV6＜ 70％적수시자행지기관서장시험.제일차조사약2년후,수진복사상술문권급폐공능검사.결과 완성2차조사급폐공능적수시자총FEV1년하강량평균치위(43 ± 114) ml(95％ CI:33 ～54 ml).흡연자여불흡연상비,FEV1년하강량분별위(64±125)화(36±109) ml,이계연대FEV1하강속도무명현영향.폐공능검사발현만조폐급기도고반응성자,기FEV1하강속도쾌우폐공능정상인군,단차이무통계학의의.령외,만성해수병사、당뇨병、관상동맥성심장병、고혈압등병사적인군FEV1하강속도균고우무상술병사자,단차이무통계학의의.재FEV1쾌속하강조(△FEV1 ≥30 ml/y)여비쾌속하강조(△FEV1＜30 ml/y)간,진행이원logistic회귀분석상술인소후발현,흡연위FEV1하강가속적독립위험인소.결론 북경시중심부분사구거민적FEV1재2년다시간내평균하강속도위(43±114) ml/y,흡연시FEV1쾌속하강적독립위험인소.
Objective To investigate risk factors correlated to the decline of FEV1 among community population in the urban area of Beijing.Method Subjects no younger than 40 years old were recruited from three communities in the urban area of Beijing.All of them were asked to fill in a questionnaire in regard to general health conditions,past medical history,medication usage,smoking history,etc.FEV1 and FEV6 were measured by Vitalograph COPD-6 spirometer using the standard protocol.Two years after the first visit,questionnaire survey and spirometry were repeated.Result Four hundred and fifty two subjects fulfilled the inclusion criteria and finished the 2nd visit,with an average age of (58.8 ±8.6) years,29％ male and 71％ female.The mean decline rate of FEV1 in the cohort was (43 ± 114) ml per year.There was no significant difference of mean FEV1 decline between different gender and age groups.A mean decline of FEV1 by (64 ± 125) ml per year was observed in smokers (including former smokers and current smokers) whereas the decline rate in non-smokers was (36 ± 109) ml per year(P =0.030).There was no significant statistical difference among current smokers,former smokers,passive smokers and subjects who never smoke.A higher decline rate of FEV1 was observed in subjects with a history of COPD or airway hyperreactivity,chronic cough,diabetes,hypertension and coronary heart disease.The difference,however,was not statistically significant.Binary logistic regression was used to screen risk factors affected the FEV1 decline rate between rapid decline (△FEV1 ≥ 30 ml/y) and non-rapid decline (△FEV1 ＜30 ml/y),and found smoking was an independent risk factor of FEV1 decline rate.Conclusion The mean rate of FEV1 decline in 2.6 years in the surveyed community population in the urban area of Beijing was (43 ± 114) ml per year;Smoking is an independent risk factor of FEV1 decline.