慢性阻塞性肺疾病患者30日再入院率与体质量指数等多因素的相关性分析

Correlation analysis between 30-day readmission rate and body mass index in patients with chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病(COPD)患者30 d再入院率与体质量指数(BMI)等多因素的相关性,为COPD的临床诊治提供理论与实际依据。方法选取2018年1月至12月广东医科大学附属第三医院呼吸内科收治的经肺功能与影像学诊断确诊的COPD患者125例,按BMI不同将其分成62例非正常体质量组(BMI<21 kg/m2或BMI>26 kg/m2)和63例正常体质量组(21 kg/m2<BMI≤25 kg/m2),通过收集2组30 d内再入院率各项临床指标与BMI数据进行临床分析与比较。结果非正常体质量组30 d再入院率,Ⅱ级、Ⅲ级、Ⅳ级等改良版英国医学研究理事会呼吸困难量表分级占比均明显高于正常体质量组,住院时间明显长于正常体质量组,0级、Ⅰ级明显低于正常体质量组,2组相比差异有统计学意义(P<0.05)。肺通气功能指标第1秒用力呼吸容积占预计值的百分比、第1秒用力呼吸容积/用力肺活量、每分钟最大通气量,氧合指数,肺容量指标深吸气量与BMI呈正相关,残气量/肺总量与BMI呈负相关。结论COPD患者气流阻塞程度与呼吸困难与30日再入院率成正比,30日再入院率越高,气流阻塞程度与呼吸困难越严重,住院时间更长,这对COPD的临床治疗提供了强有力的临床指导依据。

Objective To explore the correlation between 30-day readhospital rate of patients with chronic obstructive pulmonary disease(COPD)and body mass index(BMI)and other factors,so as to provide theoretical and practical basis for clinical diagnosis and treatment of COPD.Methods One hundred and twenty-five cases of COPD patients from January 2018 to December 2018 in the third hospital affiliated to guangdong medical university respiratory medicine were confirmed by pathology and the imaging diagnosis were selected.According to BMI different will be divided into 62 cases with abnormal body mass group(BMI<21 kg/m2 or BMI>26 kg/m2)and 63 patients with normal body mass group(21 kg/m2<BMI≤25 kg/m2),collected from two groups within 30 d reentry hospital clinical indicators and BMI data for clinical analysis and comparison.Results Abnormal body mass group within 30 d reentry hospitalization rates,Ⅱlevel,Ⅲlevel,Ⅳlevel mMRC classification of group were significantly higher than normal body quality,length of hospital stayed was longer than normal weight group,0 level andⅠlevel mMRC classification of group were significantly lower than those of normal body mass group,there was statistically significant difference in the two groups(P<0.05).The forced expiratory volume in one second as a percentage of expected value,the first second forced respiration volume/forced vital capacity,maximum air volume per minute,oxygenation index,and lung capacity index deep inspiratory volume were positively correlated with BMI,while residual air volume/total lung volume were negatively correlated with BMI.Conclusions The degree of airflow obstruction and dyspnea in COPD patients is directly proportional to the 30-day readhospital rate,and the higher the readhospital rate is,the more severe the airflow obstruction and dyspnea are,and the longer the hospital stay is,which provides a strong clinical guidance for the clinical treatment of COPD.