慢性阻塞性肺疾病患者BODE指数与生活质量的相关性研究

Study of the relationship between BODE index and life quality in patients with chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病(COPD)患者BODE指数与生活质量的相关性。方法选择COPD稳定期患者50例。计算BODE指数及其各项目的评分,包括体重指数(BMI)、气流阻塞程度(FEV1%pred)、呼吸困难(MMRC)、运动能力(6MWD)。采用St.George S呼吸问卷(SGRQ)和一般健康状况调查问卷(SF-36)评价患者的生活质量。结果50例COPD患者BODE指数评分为4.32±2.62。多元逐步回归分析发现SGRQ中影响BODE指数的因素是活动分(B=0.769,P=0.000),SF-36中影响BODE指数的因素为生理机能(PF)(B=-0.371,P=0.007)、生理职能(RP)(B=-0.340,P=0.011)和一般健康状况(GH)(B=-0.262,P=0.014)。BODE指数中MMRC与SGRQ活动分(B=-0.807,P=0.000)、SF-36的PF(B=-0.882,P=0.000)、RP(B=-0.580,P=0.000)、GH(B=-0.427,P=0.002)独立相关。结论COPD患者BODE指数和生活质量有密切的关系,BODE指数中呼吸困难对生活质量的影响最大。BODE指数高,患者呼吸困难严重,活动能力差,生活质量下降。

Objective To study the relationship between BODE index and life quality in patients with chronic obstructive pulmonary disease （COPD）. Methods A total of 50 patients with stable COPD were enrolled. BODE index and it＇s four components including body mass index（BMI）, airflow obstruction（ FEV1% ）, dyspnea （ MMRC ） and exercise capacity （6MWD） were calculated. St. George＇s Respiratory Questionnaire （ SGRQ ） and Medical Outcomes Study Short Form 36-item Questionnaire（SF-36） were used for evaluation of health-related quality of life （ HRQoL）. Results There were 47 men and 3 women in study cohort （ mean age ： 68.32 ± 7.24yr, mean BODE seores：4.32 ± 2.62）. Stepwise multiple regression analysis showed that activity scores（ B = 0.769, P = 0.000）of SGRQ,Physical Function（PF, B = - 0.371, P = 0.007）, Role-physieal（RP, B = - 0.340, P = 0.011） and General Heath（GH, B = - 0.262, P = 0.014） in SF-36 were significant influencing factors to BODE index. MMRC of BODE index were independently correlated with activity scores（ B = - 0.807, P = 0.000）of SGRQ and PF（ B = - 0.882, P = 0.000）, RP（ B = - 0.580, P = 0.000）, GH（ B = - 0.427, P = 0.002） of SF-36. Condusions BODE index and life quality had intimate relationship and dyspnea of BODE index was the most significant influencing factor to life quality. The higher BODE index is relevant to more severe dyspnea, poorer physical activity and life quality.