体质指数与COPD患者生存预后关系的回顾性队列研究

A retrospective cohort study of relationship between body mass index and long-term survival in patients with chronic obstructive pulmonary disease

目的:探讨体质指数(BMI)和慢性阻塞性肺疾病(COPD)长期生存率的关系。方法 :回顾性分析1436例COPD患者中符合条件的1 051例。死亡时间通过查询死亡登记处和民政部门确定,临床资料通过查阅病历获得。应用Cox比例风险回归模型评价全死因死亡率与BMI等因素的关系。结果:随访期间共有158例(15.0%)患者死亡,其年龄较大,病程较长,GOLD分级较高,BMI和FEV1较低,有合并症的患者较多,行长期家庭氧疗者较少。Cox多因素回归分析调整后,超重患者的死亡率较体重过低者降低了43%。生存分析证实超重组的患者生存率最高,体重过低组的生存率最低。结论:BMI对于评估COPD患者,尤其是急性加重期患者的长期预后具有一定的参考价值。

Objective To investigate the relationship between body mass index（BMI） and long-term survival in patients with chronic obstructive pulmonary disease（COPD）.Methods 1051 patients with completed data among 1436 hospitalized patients due to COPD were retrospectively analyzed.The patient′s time of death was determined by querying death registries and civil affairs departments,and clinical datas were obtained from medical records.Cox model of proportional hazards was used to evaluate the relationship between all-cause mortality and BMI.Results 158 patients（15.0%） died in the period of follow-up.They were older and had a longer clinical course,ahigher GOLD grade,a lower BMI and FEV1,more patients with complications and less patients with LTOT.In an adjusted model,overweight patients had 43% less chance of death when compared to patients with low weight.The survival curves across BMI were statistical different.Highest survival was found for overweight patients and lowest survival was found for patients with low weight.Conclusion Body mass index has a certain reference value for the assessment of long-term prognosis of patients with COPD,especially for AECOPD patients.