慢性阻塞性肺疾病患者衰弱发生情况和危险因素分析

The incidence of frailty and risk factors in people with COPD

目的探讨慢性阻塞性肺疾病(COPD)患者衰弱发生情况,危险因素分析及对日常生活活动的影响。方法连续入选解放军兰州总医院呼吸科门诊就诊和干部病房住院的COPD患者378例,男性231例,女性147例,以国际通用衰弱筛查标准评估患者衰弱发生情况。采用多因素logistic回归分析影响患者衰弱发生的危险因素,以及COPD患者合并衰弱后对日常生活活动的影响。结果纳入分析的378例COPD患者中,合并衰弱患者共169例,其中男性97例,女性72例;衰弱患病率为44.7%,其中衰弱男性占所有男性的患病率为42%,衰弱女性占所有女性的患病率为49%。COPD患者发生衰弱的可能危险因素包括年龄(每增加1岁)(OR 1.02,95%CI:1.01~1.05);合并其他慢性疾病(OR 2.13,95%CI:1.41~4.05),糖尿病病史(OR3.18,95%CI:1.32~8.27),自述爬楼气短(OR 1.94,95%CI:1.51~3.85)。COPD患者合并衰弱时,出现吃饭(OR 1.64,95%CI:1.21~2.44)、穿衣(OR 1.89,95%CI:1.32~2.92)、做饭(OR 2.21,95%CI:1.47~3.23)和做家务(OR 2.33,95%CI:1.51~3.47)等日常生活活动困难的风险增加。结论 COPD患者中衰弱发生率较高,诸多因素可影响COPD患者衰弱的发生,COPD患者合并衰弱时发生日常生活活动困难的风险明显升高。

Objective To investigate the incidence and risk factors of frailty in patients with chronic obstructive pulmonary disease（COPD）,and the impact of frailty on activities of daily living（ADL）in COPD patients. Methods A cross-sectional study was carried out in patients including outpatient of respiratory department and inpatient of department of cadre ward from General Hospital of Lanzhou Military Region of PLA. We used Fried frailty criteria to assess the incidence of frailty in patients with COPD. We also used multiple logistic regression analysis to find out the risk factors of frailty and the impact of frailty on ADL. Results A total of378 COPD patients were included in this study including 231 males and 147 females. The total incidence of frailty was 44.7%（169 patients,97 males and 72 females）,incidence of frailty was 42% for male and 49% for female. Risk factor for frailty included age（per year）（OR 1.02,95% CI 1.01 ~ 1.05）,number of co-morbidities（1）（OR 2.13,95% CI 1.41 ~ 4.05）,history of diabetes（OR3.18,95% CI 1.32 ~ 8.27）and respiratory symptom（shortness of breath on stairs/inclines）（OR 1.94,95% CI 1.51 ~ 3.85）. COPD patients with frailty had high risk for ADL [eating（OR 1.64,95% CI 1.21 ~ 2.44）,dressing（OR 1.89,95% CI 1.32 ~ 2.92）,cooking（OR 2.21,95% CI 1.47 ~ 3.23）and doing housework（OR 2.33,95% CI 1.51 ~ 3.47）]. Conclusion The incidence of frailty was high in COPD patients,many factors contribut to the occurrence of frailty in COPD patients and COPD patients has high risk of difficulty in ADL.