慢性阻塞性肺疾病患者生活质量与肺康复等因素的相关性研究  

Relationships between Health-related Quality of Life and Pulmonary Rehabilitation in Patients with Stable Chronic Obstructive Pulmonary Disease

作　　者：孙楷[1] 聂洪玉[1] 刘泳[1] 徐东兰[1] 郭万春[1] 

机构地区：[1]自贡市第四人民医院,四川自贡643000

出　　处：《四川医学》2015年第3期324-327,共4页Sichuan Medical Journal

基　　金：自贡市2011年重点科技计划(编号:17)

摘　　要：目的探讨慢性阻塞性肺疾病(COPD)患者生活质量与肺康复、肺功能指标、呼吸困难程度、运动能力等因素的关系,寻找影响COPD患者生活质量的因素。方法随机选择参加肺康复的COPD患者74例及同期未参加肺康复的COPD患者32例。测量FEV1%,应用圣乔治呼吸问卷(SGRQ)评价生活质量,改良英国MRC呼吸困难指数(mMRC)评价呼吸困难程度,6分钟步行试验(6MWT)评价运动能力及计算BODE指数。用相关分析和多元逐步回归方法分析SGRQ评分与上述因素的关系。结果 SGRQ总分与FEV1%(r=-0.223,P<0.05)、mMRC评分(r=0.850,P<0.01)、6MWT(r=-0.826,P<0.01)及BODE指数(r=0.767,P<0.01)显著相关。通过对COPD各个亚组分析,B、C、D组患者SGRQ总分均与是否参加肺康复呈负相关,相关系数分别为-0.412、-0.413和-0.344(P<0.05)。多元逐步回归分析最后仅纳入了mMRC评分、6MWT和是否参加肺康复作为SGRQ总分的独立预测变量,三者总共可以解释SGRQ总分变化的80.4%(R2=0.804,P<0.01)。结论 COPD患者生活质量与肺康复、肺功能指标、呼吸困难程度和运动能力密切相关;肺康复可以提高运动耐力、改善呼吸困难症状,提高患者的生活质量。Objective To study the relationships among health-related quality of life（ HRQL） , pulmonary rehabilitation, FEV 1%,dyspnea and exercise capacity in patients with stable chronic obstructive pulmonary disease（ COPD） ,and to find the fac-tors that affect the quality of life in patients with COPD. Methods 74 patients were randomly selected from the COPD patients who participated in the pulmonary rehabilitation program,32 patients were randomly selected from the COPD patients who did not participate in the pulmonary rehabilitation program. They were assessed for FEV 1% using spirometer,for HRQL using the Chinese version of St George’s respiratory questionnaire（ SGRQ） ,for dyspnea using the modified british medical research council（ mMRC） , for exercise capacity using the 6 minute walking test（6MWT）and calculating BODE index. The correlation and stepwise multiple regression analysis were used to analyze the correlation among SGRQ,pulmonary rehabilitation,FEV 1%,dyspnea,exercise capacity and BODE index. Results The SGRQ was correlated with FEV1%（r = -0. 223,P 〈0. 05）,mMRC score（r =0. 850,P 〈0. 01）,6MWT（r= -0. 826,P〈0. 01）and BODE index（r=0. 767,P〈0. 01）. In COPD subgroup B,C and D,SGRQ was nega-tively correlated with whether or not participated in pulmonary rehabilitation program,the correlation coefficients were -0. 412、-0. 413 and -0. 344 respectively （ P 〈0. 05 ）. Stepwise multiple regression analysis selected three variables, the mMRC score, 6MWT and pulmonary rehabilitation,as independent factors for predicting the total score of SGRQ which accounted for 80. 4 % of the total variance in the total score on SGRQ（R2 =0. 804,P〈0. 01）. Conclusion The HRQL of patients with COPD was corre-lated with pulmonary rehabilitation,FEV 1%,dyspnea and exercise capacity;pulmonary rehabilitation can improve exercise capaci-ty,symptom of dyspnea and quality of life in patients with COPD.

关 键 词：慢性阻塞性肺疾病 生活质量 肺康复 圣乔治呼吸问卷 

分 类 号：R563.9[医药卫生—呼吸系统]