双支气管舒张剂治疗慢阻肺患者的主成分因子和聚类分析  

Principal component factor and cluster analysis of dual bronchodilator therapy in patients with COPD

作　　者：喻瑞 黎友伦[1] YU Rui;LI You-lun(Department of Respiratory and Critical Care Medicine,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院呼吸与危重症医学科,重庆400016

出　　处：《临床肺科杂志》2023年第3期361-368,共8页Journal of Clinical Pulmonary Medicine

摘　　要：目的 探究双支气管舒张剂治疗的慢性阻塞性肺疾病(慢阻肺)患者异质性,比较不同类别患者之间疗效差异。方法 收集重庆医科大学附属第一医院予以双支气管舒张剂吸入治疗的住院慢阻肺患者临床资料,通过主成分因子和聚类分析将患者分类,比较类别间症状、生活质量改善情况,进行生存分析。结果 研究中81例慢阻肺患者最终分为3类。各类别特征总结,第1类:中度肺功能损害、药物依从性好、更多的合并症、较少的肺部感染、预后好。第2类:轻度肺功能损害、药物依从性差、更少的合并症、很多的肺部感染、预后较差。第3类:重度肺功能损害、药物依从性差、较多的合并症、较少的肺部感染、较高的PaCO_(2)、预后差。结论 主成分因子及聚类分析在慢阻肺归类研究和预测预后方面具有较高的临床价值。依从性可作为综合评估患者病情及预后的指标之一,进行针对性干预应该是慢阻肺治疗的未来目标。Objective To explore the heterogeneity of patients with chronic obstructive pulmonary disease(COPD) treated with dual bronchodilators, and to compare the efficacy differences among different categories of patients. Methods The clinical data of inpatient COPD patients treated with dual bronchodilators in the First Affiliated Hospital of Chongqing Medical University were collected. The patients were classified by principal component factor analysis and cluster analysis, the symptoms and quality of life were compared between categories, and survival analysis was performed. Results The 81 COPD patients in the study were finally divided into three categories. Summary of the characteristics of each category, category 1: moderate lung function impairment, good medication adherence, more comorbidities, fewer pulmonary infections, and good prognosis. Category 2: mild lung function impairment, poor medication adherence, fewer comorbidities, many pulmonary infections, poor prognosis. Category 3: Severe lung function impairment, poor medication adherence, more comorbidities, fewer pulmonary infection, higher PaCO_(2), and poor prognosis. Conclusion Principal component factors and cluster analysis have high clinical value in the classification of COPD and prediction of prognosis. Compliance can be used as one of the indicators to comprehensively evaluate the condition and prognosis of patients, and targeted intervention should be the future goal of COPD treatment.

关 键 词：慢性阻塞性肺疾病 双支气管舒张剂 主成分因子分析 聚类分析 

分 类 号：R563.9[医药卫生—呼吸系统]