| Objective:To explore the risk factors of COPD for residents in Kashgar, Xinjiang, and to identify the factors influencing life quality of patients with COPD in order to provide clues for pathogen research of COPD and to provide scientific basis for making policy for prevention and treatment for COPD in Kashgar, Xinjiang.Methods:A hospital-based case-control study was conducted. A uniform questionnaire for cases and controls was used to investigate the medical records. The patients aged40to92years were recruited from the second people’s hospital in Kashgar, Xinj iang between Mar of2011and Jun of2012. The patients were diagnosed as COPD according to Global Initiative for Chronic Obstructive Lung Disease(GOLD). Each patient was matched with a control with same age(士5yrs), gender, ethnicity. The controls, rule out the respiratory diseases, liver diseases and kidney diseases, were patients in the same hospital during the same period. The survey included demographic, family history of COPD, smoking status, passive smoking, dust exposure, biomass fuel exposure, kitchen equipment, nutrition status and laboratory data. The questionnaire was designed by experts of epidemiology and respiratory. COPD Assessment Test (CAT) was used to assesse patients’ life quality. Epi data was used to input and manage database. Univariate and multivariate logistic regression analysis were conducted to explore risk factors of COPD by SPSS20.0software.Results:Totally,256patients were recruited in the study; The128patients diagnosed as COPD were matched with128controls. There were21(16.4%) Hans and107(83.6%) Uyghurs in case group and control group. The mean ages of patients and controls (mean±SD) were (62.7±10.5) years and (64.0±9.7) years, respectively. No significant differences were found between patients and controls in demographic characteristics. Univariate logistic regression model showed that BMI, nutrition status, biomass fuel exposure, coal burning, dust exposure, kitchen ventilator, smoking and passive smoking in house and workplace were associated with COPD. Six risk factors and one protective factor were ascertained by multivariate logistic regression analysis, which were malnutrition (OR=6.4,95%CI:3.3-8.7), smoking (OR=6.5,95%CI:1.9-22.2), biomass fuel exposure (OR=7.6,95%CI:3.7-9.3), passive smoking in family (OR=2.2,95%CI:1.5-10.0), passive smoking in workplace (OR=8.2,95%CI:1.2-56.6); The dose-response relationship was found between years of dust exposure and prevalence of COPD. Better kitchen ventilation was protective factor to COPD. Multivariate linear regression analysis indicated that biomass fuel exposure0=1.973,95%CI:0.126-3.820), dust exposure(β=2.982,95%CI:0.956-5.009), smoking(β=1.557,95%CI:0.374-3.487) were positively associated CAT; kitchen ventilation(β=-2.314,95%CI:-3.546--1.081), FEV1%(β=-0.082,95%CI:-0.144--0.021) and FEV1/FVC(β=-0.126,95%CI:-0.234--0.081) were negatively associated with CAT.Conclusion:The result indicates biofuel exposure and dust exposure were environment risk factors related to COPD, smoking and passive smoking were behavioral risk factors to COPD, and all of above also negatively impact life quality of patients with COPD in Kashgar, Xinjiang. Better kitchen ventilation is protective factor to COPD, which also related to better life quality of patients with COPD. Based on the conclusion, the outbreak of COPD is highly associated with environmental and behavioral factors. It is suggested that environmental and behavioral risk factors should be paid more attention to prevent COPD. |
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