中国七省市慢性阻塞性肺疾病患者的生命质量现况调查  

The quality of life of patients with chronic obstructive pulmonary disease and correlated factors

作　　者：周玉民[1] 王辰[2] 姚婉贞[3] 陈萍[4] 康健[5] 黄绍光[6] 陈宝元[7] 王长征[8] 倪殿涛[9] 王小平 王大礼[11] 刘升明[1] 吕嘉春[12] 郑劲平[1] 钟南山[1] 冉丕鑫[1] 

机构地区：[1]呼吸疾病国家重点实验室(广州医学院第一附属医院),510120 [2]首都医科大学附属北京朝阳医院-北京呼吸疾病研究所 [3]北京大学第三医院呼吸内科 [4]沈阳军区总医院呼吸内科 [5]中国医科大学附属第一医院呼吸疾病研究所 [6]上海交通大学医学院附属瑞金医院呼吸内科 [7]天津医科大学总医院呼吸内科 [8]第三军医大学新桥医院呼吸内科 [9]第四军医大学西京医院呼吸内科 [10]广东韶关市第一人民医院呼吸内科 [11]广州市荔湾区第二人民医院呼吸内科 [12]广州医学院公共卫生与全科医学学院

出　　处：《中华结核和呼吸杂志》2009年第4期248-252,共5页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：基金项目：国家“十五”攻关课题资助项目[2001BA703803（A）];广东省“十五”重点支持项目资助项目（B30301）

摘　　要：目的评估COPD患者的生命质量及其影响因素。方法2002--2004年对北京、上海、广东、辽宁、天津、重庆和陕西等7个地区城乡40岁及以上人群进行COPD横断面调查，对入选的20245人进行问卷调查和肺功能检测，采用12个条目的简短生命质量量表（SF-12）评估生命质量，支气管舒张试验后FEV1／FVC〈70％者诊断为COPD。SF-12评分经秩转换后采用一般线性模型分析比较各组间的差别。采用多因素逐步线性同归分析方法分析影响生命质量的因素。结果与非COPD患者相比，COPD患者的生命质量下降，心理成分评分分别为（56±7）分和（57±6）分，躯体成分评分分别为（46±9）分和（50±6）分，差异均有统计学意义（F值分别为4．442和453．960，P〈0．05和P〈0．01）。COPD患者的心理成分评分主要受气促严重程度、体重指数、合并疾病、性别和居住在城乡的影响；COPD患者的躯体成分评分主要受气促严重程度、合并疾病、性别、COPD分级、职业粉尘烟雾暴露史、年龄、文化程度和既往诊断COPD的影响。结论COPD患者的牛命质量下降，并与气促和疾病严重程度、体重指数和合并疾病密切相关。改善气促症状，加强营养支持，减少合并疾病，远离危险因素的暴露可以改善COPD患者的生命质量。Objective To evaluate the quality of life （QOL） of patients with chronic obstructive pulmonary disease （COPD）and correlated factors. Methods Data of 20 245 patients with COPD were collected from the cross-sectional survey of COPD, which was conducted between 2002 and 2004 in urban and rural areas of Beijing, Shanghai, Guangdong, Liaoning, Tianjin, Chongqing and Shanxi for residents aged over 40 years old. The recruited populations were interviewed with questionnaire and tested for spirometry. The quality of life was assessed with 12-item short-form health survey questionnaire （SF-12）. Those with less than 70% of post-bronchodilator FEV1/FVC were identified as having COPD. The differences between groups in SF-12 scores converted by rank were compared using general linear model. Stepwise multiple linear regressions were conducted to study the main determinants of QOL. Results Compared to subjects without COPD, those with COPD had impaired QOL （56 ± 7 vs. 57 ± 6 in mental component scores, F = 4. 442, P 〈 0. 05 ; 46 ± 9 vs. 50 ±6 in physical component scores, F = 453. 960, P 〈 0.05 ）. Among COPD patients, the mental component score was associated with scores of dyspnea, BMI, comordities, sex and living areas, while the physical component score was associated with scores of dyspnea, severity of COPD, comordities, exposure to dusts/gases/fumes, sex, age, educational level and previous diagnosis of respiratory diseases （ all P 〈 0. 05 ） . Conclusions The QOL in patients with COPD was impaired and associated with scores of dyspnea, severity of COPD, comordities and BMI. Improvement of dyspnea, nutritional support, prevention of comordities and keeping away from risk factors may improve the QOL in COPD patients.

关 键 词：肺疾病 慢性阻塞性 生活质量 量表 

分 类 号：R686[医药卫生—骨科学]