[Investigation of the chronic respiratory symptoms and pulmonary function of adult residents in Hongtong County, Shanxi Province].

Objective: To investigate the chronic respiratory symptoms and pulmonary function of adult residents in 3 towns of Hongtong County, Shanxi Province, and to explore their risk factors. Methods: The investigation of chronic respiratory symptoms and lung function status of adult residents in Hongdong County is based on the regional population of the entire county in Hongdong County. The project was initiated by the Science and Technology Department of Linfen City and coordinated by the Hongdong County Government. The investigation will be conducted in 3 townships in Hongdong County, Linfen City, Shanxi Province from April to November 2021: Demographic characteristics, respiratory symptoms, smoking dust exposure and other personal history were collected through questionnaires. Physical examination, routine blood tests and lung function tests were also performed on each individual. SPSS 22.0 software was used to conduct t test, χ2 test, ANOVA or Kruskal-Wallis test for statistical analysis of the collected information. Results: 10 945 subjects aged 18-102 years were included in the analysis, of whom 3 754 (34.3%) were male, 1 222 (11.2%) had a history of dust exposure, 7 164 (65.5%) had used straw and firewood as cooking fuel, and 3 296 (30.1%) had a history of smoking. Among the participants, 394 (3.6%), 339 (3.1%), and 1 543 (14.1%) had respiratory symptoms such as chronic cough, sputum, and dyspnea. Statistics showed that the population with chronic respiratory symptoms was more elderly and had a smoking history, and the incidence of chronic respiratory symptoms was higher in those who smoked more than 40 packs a year (all P<0.05). Men with a history of dust exposure were more likely to suffer from chronic cough and expectoration, while emaciation and biofuel use for more than 40 years were more likely to suffer from chronic expectoration and dyspnea (all P<0.05). The median values of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and FEV1/FVC in 1 second were 2.19 L/s, 3.24 L and 69.16%, respectively. Among them, the lung function of 5 801 (53.0%) respondents was lower than the expected value. The median FEV1/FVC decreased with the increase of age. The FEV1/FVC of people over 40 years old with smoking history was lower, the dust exposure history of people with decreased lung function was more than that of people with normal lung function, and the incidence of chronic expectoration and dyspnea was higher in people with decreased lung function (all P<0.05). The absolute value and ratio of eosinophils in patients with decreased ventilation function over 60 years old were significantly higher than those with normal ventilation function, but the level of body mass index (BMI) was lower (all P<0.05). Conclusion: In Hongdong County, Shanxi Province, grassroots residents have poor medical awareness, low lung function examination rate, chronic respiratory symptoms and lung function decline are associated with more risk factors. Primary medical institutions need to formulate prevention strategies and carry out lung function detection according to the actual situation, focusing on monitoring and follow-up of high-risk groups to achieve early and timely prevention, diagnosis and treatment of chronic obstructive pulmonary disease.目的： 调查山西省洪洞县3个乡镇成年居民的慢性呼吸系统症状及肺功能情况，并探讨其影响因素。 方法： 洪洞县成年居民慢性呼吸系统症状及肺功能现状调查是以洪洞县全县全员区域性人群为基线，由临汾市科技厅立项，洪洞县政府协调，于2021年4至11月选择山西省临汾市洪洞县3个乡镇进行调查：通过调查问卷，收集研究对象的人口学特征、呼吸系统症状、吸烟粉尘暴露等个人史；此外还对每个调查个体进行体格检查、血常规化验及肺功能检查。利用SPSS 22.0 软件进行t检验、χ2 检验和方差分析或Kruskal-Wallis 检验对所收集信息进行统计学分析。 结果： 10 945名研究对象纳入分析，年龄范围18~102岁，其中男性3 754人（34.3%），有1 222人（11.2%）具有粉尘暴露史，7 164人（65.5%）曾使用秸秆及柴草作为烹饪燃料，3 296人（30.1%）有吸烟史。纳入研究对象中分别有394人（3.6%）、339人（3.1%）、1 543人（14.1%）存在慢性咳嗽、咳痰、呼吸困难等呼吸系统症状。统计发现具有慢性呼吸系统症状的人群高龄、有吸烟史的人群占比更高，且吸烟量大于40包年者慢性呼吸系统症状发生率更高（均P<0.05）。男性、有粉尘暴露史者更容易患有慢性咳嗽、咳痰，而消瘦、生物燃料使用史超过40年者更易出现慢性咳痰和呼吸困难（均P<0.05）。被调查者肺功能1秒用力呼气容积（FEV1）、用力肺活量（FVC）、FEV1/FVC中位数分别为2.19 L/s、3.24 L、69.16%，其中5 801名（53.0%）被调查者肺功能较预计值下降；随着年龄增长，FEV1/FVC中位数逐渐下降；40岁以上人群中有吸烟史者的FEV1/FVC较低，肺功能下降人群中有粉尘暴露史者较肺功能正常人群更多，且慢性咳痰、呼吸困难在肺功能下降人群中发生率较高（均P<0.05）。而在60岁以上通气功能下降的人群中嗜酸性粒细胞绝对值和比值较通气功能正常者显著增高，但身体质量指数（BMI）水平较低（均P<0.05）。 结论： 山西省洪洞县基层居民就医意识差，肺功能检查率低下，慢性呼吸系统症状和肺功能下降均有较多危险因素，基层医疗机构需要根据实际情况制定预防策略并开展肺功能检测，重点监测并随访高危人群。.