| objective:To investigate the prevalence of chronic obstructive pulmonary disease(copd)among residents of Mianyang,its diagnosis,treatment status and mental health status of patients and analyze the risk factors related to its occurrence,This research provide objective basis for the prevention,treatment and psychological intervention of copd and the formulation of relevant policies.Methods From January 2018 to March 2018.144 towns 107 townships and15 streets of of Mianyang were selected,Youxian district streets,Xiaojiangou town of Mianyang,Zhongba town of Jiangyou and Zhangming town were randomly selected.Then,a community or a natural village(Dongcai factory community,Ziyang village,Changming community of Jiangyou and Nanjiang village of Jiangyou)were selected respectively from the appeal streets/towns as the investigative respondents.There are 1145 subjects aged ?40 year-old(similar number each point)were selected in a total of four points as investigative responds.With pulmonary function qualified,1116 subjects are effective to complete the questionnaires,percent of pass is: 97.5%.After inhaled bronchodilator,FEV1 / FVC < 70% and excluding by other medical history,chest X-ray,electrocardiogram(ecg)can affect the lung function of other heart and lung disease as an standard to diagnose copd.All respondents collect relevant information including: gender,age,residents type,degree of culture marital status),smoking status,(the age of start smoking,daily consumption of cigarettes,somking for long,non-smokers haveing passive smoking and passive smoking for long)fuel usage(fuel type,use fixed number of year,heating,cooking habits)dust exposure history and fill in the contact with fixed number of year.Total 91 patients(patient group)with COPD who met the diagnostic criteria of 2018 Global Initiative for Chronic Obstructive Lung Disease(GOLD)were included in the survey.At the same time,80 healthy people with normal lung function were selected as the control group at the four sites mentioned above.The quality of life and the degree of dyspnea in patient group were assessed by the COPD Assessment Test(CAT)and modified British Medical Research Council(m MRC).The symptoms of anxiety and depression were assessed by the Hamilton Anxiety Scale(HAMA)and the Hamilton Depression Scale-17 item,(HAMD-17).Epi Data3.1 software was used to input data for the questionnaire survey by two persons,using SPSS 20.0 for statistical analysis.Counting data is represented by examples and percentages(%),prealence rate and univariate comparison was made by ?2 test or Fisher's exact test.The measurement data are expressed as(x±s).HAMA and Hamd-17 scores of the two groups were compared by independent sample t test.Binary Logistics regression analysis was used to explore the risk factors of the incidence of COPD patients and the risk factors of anxiety and depression in COPD patients,with P<0.05,the difference was considered statistically significant.Results:(1)A total of 1145 subjects were investigated but there were 1116 subjects with full data and good quality spirometry test,including 482 males and 634 females,91 subjects were diagnosed with COPD,the overall prevalence of COPD in Mianyang is 8.1%.(2)The prevalence of COPD in the males was11.6%,and 5.3% in the females.The prevalence of COPD in the males was significantly higher than that in the females,the difference was statistically significant(?2=14.4,P=0.000)(3)The prevalence of COPD in Changming community was 12.0%,the prevalence of COPD in Dongcai factory community was 8.7%,the prevalence of COPD in Ziyang village was 4.9%,the prevalence of COPD in Nanjiang village was 5.7%.The prevalence of COPD in urban was10.3% and 5.3% in the rural,there is the difference between the rural and urban in the prevalence of COPD,the difference was statistically significant(?2=9.276,P=0.002).(4)Grouping by every 10 years old to Stratifiy comparison,the different of the prevalence of COPD among 40~49 years old?50~59 years old?60~69 years old and more than 70 years old were 4.9%?4.3%?6.7% and 14.0%.the prevalence of COPD increased with age increasing,and The difference was statistically significant(?2=21.408,P=0.000)(5)91 patients diagnosed with copd,74 patients accompaned with cough,sputum breathing difficulties.The symptomatic rate was 81.3%,the rate of symptomatic rate of men and women have symptoms of comparison,The difference was not statistically significant(? 2 = 0.038,P = 0.845).(6)The prevalence of COPD in the nonsmokers:5.2%,in the current smokers: 10.2%,in the smoking cessation: 18.2%,and the differences were significance,(?2=34.705,P=0.000)(7)In smokers,.Grouping by every 10 Smoking count,divided into ?10;11-20;21-30;>30,the prevalence of COPD were: 12.9%;17.4%;27.8%;31.6%,the higher the daily smoking,the higher the prevalence of COPD,and the difference was significance(?2=8.148,P=0.036).(8)Subjects who had used firewood in the past group by every 5years,dividing into1-5years;6-10 years;11-15years;more than15 years,the prevalence of COPD were:0%;3.0%;8.1%;18.4% the higher the the years of firewood burning,the higher the prevalence of COPD,and the difference was significance(?2=8.419,P=0.030)(9)The prevalence of COPD with occupational dust exposure history was 13.9%,without dust exposure history was 7.0%,The prevalence of COPD with occupational dust exposure history was higher than that without occupational dust exposure history,and the difference was statistically significant(?2=9.014,P=0.03).(10)using binary logistic regression analysis results: the gender was male the increasing age urban residents Smoking having a family history of respiratory disease having a occupational dust exposure history,which is related to the prevalence of copd.(11)The detection rates of anxiety and depression symptom was 29.7%;24.2%respectively in patient group.In the control group,the detection rate of anxiety and depression symptom was 5.0%,2.5%.The detection rates of anxiety and depression symptom in the patients group were higher than those in the control group(P=0.025;P=0.008).(12)Among COPD patients,the difference of economic burden between the anxious group and the non-anxious group was statistically significant(P=0.015),and the differences of m MRC score and economic burden between the depressed group and the non-depressed group were statistically significant(P=0.040;P=0.032)Conclusion The prevalence of COPD in Mianyang is 8.1%.The prevalence of COPD in the males was higher than that in the females.The prevalence of COPD increased with age increasing.The prevalence of COPD in the smoker was higher than that in nonsmoker.The higher the daily smoking,the higher the prevalence of COPD.The higher the the years of firewood burning,the higher the prevalence of COPD.The prevalence of COPD with occupational dust exposure history was higher than that without occupational dust exposure history.Patients Patients with copd screened by epidemiological investigation may have anxiety and depression symptoms,gender and age may be risk factors for anxiety.CAT score,m MRC score and financial burden may not be related to anxiety and depression.It is necessary to strengthen tobacco control and dust exposure prevention,reduce the use of media and firewood to achieve the purpose of prevention and treatment of copd,and pay attention to the mental health of copd patients. |
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