COPD患者病情严重程度与生活质量的相关性研究

Relationship Between Disease Severity and Life Quality in Patients with Chronic Obstructive Pulmonary Disease

目的比较COPD患者BODE指数(B为体重指数,O为气流阻塞,D为呼吸困难,E为运动能力)与GOLD分级用于评估病情严重程度的价值,探讨BODE指数与患者生活质量的相关性。方法选择COPD稳定期患者100例。采用圣乔治呼吸问卷(SGRQ)评价患者的生活质量并对其进行肺功能测试。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)。受试者分别根据GOLD分级标准和BODE指数分为四组,通过SGRQ评分对GOLD分级和BODE指数进行比较。结果 BODE指数与COPD患者的SGRQ总分、问卷各部分评分均呈显著的相关性(P<0.01)。BODE指数可以较好地预测患者的生活质量,能解释41.3%的SGRQ总分(P<0.01)。然而GOLD分级仅与SGRQ活动能力分值呈相关性(P<0.05),同SGRQ其他评分并无相关。根据BODE指数划分的各组患者中,SGRQ总分和其他部分评分均有明显差异(P<0.01),但是按照GOLD分级标准划分的各组患者中,除活动能力分值外(P<0.01),其余各组的SGRQ总分和各部分评分无明显差异。结论 BODE评分系统与GOLD分级相比,能更好的评价不同严重程度COPD患者病情与其生活质量的相关性。

Objective To compare BODE index with GOLD staging for the severity evaluation in patients with chronic obstructive pulmonary disease（COPD）.To investigate the relationship between BODE index and quality of life.Methods A total of 100 patients with stable COPD were enrolled.All participants were examined with lung function test and St George＇s Respiratory Questionnaire （SGRQ） for evaluation of quality of life.BODE index and it＇s four components including body mass index（BMI）,airflow obstruction（FEV1%pred）,dyspnea（MMRC）,and exercise capacity（6MWD） were calculated.The participants were divided into four groups of severity using GOLD guidelines and BODE index quartiles.Results The associations between SGRQ total score and SGRQ subscales,and BODE index were significant（P0.01）.BODE index was a significant predictor of the quality of life,explaining 41.3% of the total score of the SGRQ（P0.01）.However,GOLD classification showed a correlation only with SGRQ activity score（P0.05） but not with other SGRQ scores.There were significant differences in SGRQ total score and SGRQ subscales between different severity groups of BODE index（P0.01）.But there was no difference in SGRQ score between different severity groups of GOLD classification,except SGRQ activity score.Conclusion BODE scoring system is better correlated with the quality of life as assessed by the disease severity in patients with COPD than the GOLD staging criteria.