基于广东省人群调查的慢性阻塞性肺疾病严重度分布构成及其生活质量状况

The proportion and quality of life of patients with chronic obstructive pulmonary disease among population in Southern China

目的 评估人群COPD的严重程度分布构成及其生活质量状况.方法 基于广东省城乡40岁及以上的人群的COPD横断面调查.入选的人群都进行问卷调查和肺功能检测,支气管扩张试验后1秒率（FEV1/FVC） ＜0.70者诊断为COPD.生活质量采用12个条目的简短生活质量量表（12-itemShort-Form health survey questionnaire,SF-12）进行评估,严重程度按慢性阻塞性肺疾病全球防治创议（GOLD）的A、B、C、D分级,采用改良的英国医学研究委员会气促评分量表、气流受限程度（FEV1,FEV1％pred）和过去一年症状加重的次数进行综合评估.结果 流调人群中经肺功能检查确诊的COPD A、B、C、D各组的构成分别为36.0％ （109/303）、25.4％（77/303）、12.5％ （38/303）和26.1％（79/303）;其躯体成分评分分别为49.28±4.25、43.21±7.94、44.67±7.90和37.45±9.68,各组之间总体差异有统计学意义（F =39.593,P＜0.001）,各组之间两两比较,除B组与C组之间差异无统计学意义外,其余各组之间差异有统计学意义（P值均＜0.05）;心理成分评分分别为57.62±3.31、57.89±4.25、57.22±4.83、55.63±7.95,各组之间总体差异有统计学意义（F=2.978,P=0.032）,各组之间两两比较,除D组与A、C两组之间差异有统计学意义外（P值均＜0.05）,其余各组之间差异无统计学意义.结论 人群中COPD严重度各组分布构成以A组最高,C组最少,生活质量以A组受损最少,D组受损最严重.

Objective To assess the severity distribution proportion and quality of life （QOL） of chronic obstructive pulmonary disease（COPD）among population in Southern China.Methods Data were from the cross-sectional survey of COPD which was conducted in an urban and a rural of Guangdong for residents aged over 40 years old.The recruited populations were interviewed with questionnaire and were tested with spirometry.Those with less than 70% of post-bronchodialator FEV1/FVC were identified as the COPD.The quality of life was assessed with 12-item Short-Form health survey questionnaire （SF-12）.Groups （A,B,C and D） were classified according to GOLD using combination of mMRC,FEV1 %pred and acute exacerbation of COPD in last year.Results Three hundred and three patients with COPD indentified by spirometry testing among population,there were 109 （36.0 %）,77 （25.4 %）,38 （12.5 %）and 79 （26.1 %） patients in Group A,B,C and D,respectively.There was statistically difference between each two groups in physical component scores of SF-12 （F =39.593,P 〈0.001） except for difference between Group B and C,with 49.28±4.25,43.21±7.94,44.67±7.90 and 37.45±9.68 for Group A,B,C and D,respectively.A statistically difference was found between four groups in mental component scores of SF-12 （F =2.978,P =0.032）,with 57.62±3.31,57.89±4.25,57.22±4.83,55.63±7.95 for Group A,B,C and D,respectively.Group D had a lower mental component scores of SF-12 compare to Group A and C （both P 〈0.05）.Conclusions Group A is the highest proportion in population with a minimum of impaired quality of life,and Group D has the most serious damage of quality of life.