[俄罗斯极北地区居民呼吸道症状的流行程度]。

S. Andronov, A. Lobanov, A. Popov, A. Emelyanov
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引用次数: 1

摘要

目的研究俄罗斯远北亚马尔地区驯鹿牧民呼吸道症状的发生频率。我们对500名苔原涅涅茨人(占该地区成年涅涅茨人口的28.1%)的呼吸道症状发生情况进行了横断面研究,其中38.3%为男性,61.7%为女性(平均年龄40.1岁)。所有患者的年龄和职业相匹配。一名肺科医生使用GARD问卷(世卫组织,2004年)和肺活量测定法进行了医学检查。肺活量测定采用SpiroUSB(英国)设备,按照ATS/ERS 2005的统一标准和标准进行。冻土带人群中出现呼吸道症状的频率估计为71.8%。咳嗽伴咳痰、呼吸困难者占22.8%。70.0%的被调查者在寒冷环境中工作,33%的人在家暴露在明火下,34.4%的人吸烟。在寒冷环境中工作的人中有16.3%出现呼吸道症状,暴露于明火的人中有37%出现呼吸道症状。吸烟者咳嗽、咳痰的发生率是不吸烟者的两倍(54.1%)(p<0.01)。咳嗽、咳痰是吸烟人群的两倍(54.1% vs 20.2%) (p<0.01)。合并这些问题的呼吸困难在吸烟者中是前者的三倍(23.3% vs 7.3%) (p<0.001)。在病人在场的情况下,如在寒冷中工作,而没有其他因素,只有16.3%的人有呼吸道症状。在家中使用时,明火和没有其他因素导致37.0%的个体出现慢性支气管炎症状。当吸烟是唯一的危险因素时,只有26.3%的吸烟者会出现咳嗽、痰和呼吸困难。若被调查居民呼吸道症状的三种阴性因素均达到62.1%。根据肺活量测定,在所有研究参与者中均未观察到呼吸功能障碍。暴露于所有三种危险因素的受试者中有62.1%出现呼吸道症状。所有检查对象的外呼吸指标均正常。结论是,远北地区居民经常出现呼吸道症状,但外部呼吸功能没有紊乱。在大多数情况下,它们与三个因素有关(在寒冷的环境中工作,暴露在家里的明火中,吸烟)。肺功能代偿性刺激可能给支气管梗阻的诊断带来额外的困难。
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[THE PREVALENCE OF RESPIRATORY SYMPTOMS AMONG RESIDENTS OF THE RUSSIAN FAR NORTH].
Aim To study the frequency of respiratory symptoms among the reindeer herders of the Yamal region in the Far North of Russia. We conducted a cross-sectional study of the occurrence of respiratory symptoms among 500 subjects of the tundra Nenets population (28.1% of the adult Nenets population in the district), of which 38.3% were men and 61.7% women (average age 40.1 years). All patients were matched for age and occupation. Medical examination was carried out by a pulmonologist with the use of the GARD questionnaire (WHO, 2004) and spirometry. Spirometry was performed with a SpiroUSB device (UK) according to a unified standard and the criteria of ATS/ERS 2005. The frequency of respiratory symptoms among the tundra population was estimated at 71.8%. Cough with expectoration and dyspnea were found in 22.8% of the respondents. 70.0% of the examined subjects worked in the cold, 33% were exposed to the open flame at home, and 34.4% smoked. Respiratory symptoms developed in 16.3% of those working in the cold and in 37% exposed to open fire. The combination of such complaints as cough and sputum production occurred in smokers twice as frequently as in non-smokers (54.1%) (p<0.01).The combination of such complaints as cough and sputum production was twice as likely note in his those who smoked (54.1% vs 20.2%) (p<0.01). The combination of these problems dyspnea was three times more common in the smokers (23,3%vs 7,3%) (p<0.001). At presence at patients of such a factor as work in the cold and the absence of other only 16.3% of them have respiratory symptoms. When using at home the open flame and the absence of other factors leading up 37.0% of the individuals with symptoms of chronic bronchitis. Cough, sputum and dyspnea are formed only among 26.3% of the smokers face when smoking is the only risk factor. If the surveyed residents of all three negative factors respiratory symptoms met at 62.1%. Disorders of respiratory function according to spirometry were not observed in none of the study participants. Respiratory symptoms developed in 62.1% of the subjects exposed to all three risk factors. External respiration indices remain normal in all he examine subjects. It is concluded that residents of the Far North frequently suffer respiratory symptoms without disorders in the external respiratory function. In most cases they associated with three factors (work in the cold, exposure to open fire at home, and smoking). Compensatory stimulation of lung functions may create additional difficulties for diagnostics of bronchial obstruction.
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