慢性阻塞性肺疾病患者生命质量及其相关因素分析

lnflunencing factors of quality of life in patients with chronic obstructive pulmonary disease

目的对慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）患者生命质量及其相关因素进行分析。方法选择山西医科大学第一医院呼吸内科门诊及住院稳定期慢性阻塞性肺疾病患者126例。选用由蔡映云教授等设计的慢性阻塞性肺疾病生命质量测量表对患者进行评估。据COPD患者人口学特征、流行病学特征和临床诊治经验对可能影响患者生命质量并有可能进行干预的11项因素进行调查和分析，包括年龄、职业、营养状况、受教育程度、经济状况、吸烟量、呼吸困难程度、急性加重频率、体育锻炼、共患疾病、第1秒用力呼气容积占预计值的百分比和动脉血氧分压。结果纳入COPD患者126例，所填问卷均完整、准确，全部进入结果分析。①动脉血氧分压对生命质量总分及日常生活能力有影响，其标准回归系数B分别为-0．192、和-0．205，t分别为-3．202和-2．791，P值均〈0．01。②呼吸困难程度对生命质量总分和日常生活能力、焦虑心理症状和抑郁心理症状3个因子均有影响，标准回归系数β分别为0．204、0．265、0．264和0．366，t分别为2．841、3．487、2．982和4．582，P值均〈0．01。③肺功能对日常生活能力和社会活动状况两个因子有影响，其标准回归系数β分别为0．173和0．205，t分别为2．013和2．503，P值均〈0.01。结论影响COPD患者生命质量的主要因素有年龄、体质量指数、体育锻炼、共患疾病、急性加重次数、呼吸困难程度、啼功能和动脉血氧分压。根据标准回归系数的大小可以看出，各因子对生命质量总分的影响从大到小依次为体育锻炼、急性加重次数、呼吸困难程度、动脉血氧分压、共患疾病、体质量指数和年龄。

Objective To study the major factors which could affect the quality of life in patients with chronic obstructive pulmonary disease（COPD）. Methods One hundred and twenty-six inpatients or outpatients with stable COPD were selected from the Department of Respiratory Medicine, the first Hospital of Shanxi Medical University between August 2006 and November 2007. The quality of life of the patients were measured with COPD questionaire designed by professer CAI Yin-yun in shanxi. Based on the demographic characteristics investigation, epidemiologic feature and clinical experience of diagnose and therapia of the patients with COPD, 11 factors, which may be interfered in, were investigated and analysed including age, employment, economic status, nutritional status, smoking condition, dyspnea degree, the frequency of acute exacerbation, physical exercise, comorbidity, forced expiratory volume in first second （FEV1） and partial pressure of oxygen of artery （PaO2）. Results All the questionnaires filled by the 126 patients were accurate and complete,and all were involved to the analysis of results. ①Partial pressure of oxygen of artery affected the total scores and activity of daily living（standard regression coefficient β was - 0. 192 and - 0. 205, t =- 3. 202 and -2. 791, all P 〈0. 01. ② Dyspnea degree affected the toal scores and 3 dimensions including activity of daily living, anxious psychological symptom and depressed psychology symptom （ standard regression coefficient β was 0. 204,0. 265,0. 264, and 0. 366, t = 2. 841,3. 487, 2. 982 and 4. 582, all P〈0.01）. ③Lung function affected activity of daily living and social activities condition （standard regression coefficientβ was 0. 173 and 0. 205, t= 2. 013 and 2. 503, all P 〈0.01）. Conclusions The major factors which affect the quality of life of stable COPD patients are age, BMI, physical exercise, comorbidity, the frequency of acute exacerbation, dyspnea degree, pulmonary ventilation function and PaO2. According to standard rgression coefficient β, we can learn about that the main factors that influence total scores are physical exercise, the frequency of acute exacerbation, dyspnea degree, PaO2, comorbidity, BMI and age.