稳定期慢性阻塞性肺疾病患者报告结局现状及影响因素分析

目的 了解稳定期慢性阻塞性肺疾病 (chronic obstructive pulmonary disease,COPD) 患者报告结局现状,分析其影响因素及与炎症指标的相关性,为开展以患者为中心的早期护理干预提供依据。 方法 采用便利抽样法,选取2020年10月—2021年7月于南宁市某三级甲等医院呼吸内科门诊就诊的稳定期COPD患者作为调查对象,采用一般资料调查表、COPD患者报告结局量表修订版 (the Modified Patient-Reported Outcome Scale for COPD,mCOPD-PRO) 进行调查,并收集患者就诊时炎症指标的结果。采用多元线性回归分析稳定期COPD患者报告结局的影响因素,采用相关性分析探讨患者报告结局与炎症指标的关系。结果 该研究共纳入204例稳定期COPD患者,mCOPD-PRO得分为 (1.75±0.58) 分。多元线性回归分析显示,性别、合并疾病数量、病程、肺功能分级是稳定期COPD患者报告结局的影响因素 (P<0.05),可解释稳定期COPD患者报告结局10.8%的总变异。相关性分析显示,白细胞计数、中性粒细胞计数、嗜酸性粒细胞计数与稳定期COPD患者的mCOPD-PRO得分呈正相关 (P<0.05) ;总白蛋白浓度与其呈负相关 (P<0.05) 。结论 稳定期COPD患者报告结局有待改善,女性、合并疾病数量>3种、病程较长、肺功能分级较高的COPD患者报告的结局较差。COPD患者报告结局与白细胞计数、中性粒细胞计数、嗜酸性粒细胞计数、总白蛋白浓度相关。护理人员应关注稳定期COPD患者报告结局及炎症指标,在早期采取针对性的干预措施,以改善患者的生活质量。

The current status of patient reported outcomes and its influencing factors in patients with stable chronic obstructive pulmonary disease

Objective To analyze the influencing factors of patient reported outcomes in patients with stable chronic obstructive pulmonary disease (COPD) and the correlation with inflammatory indexes,so as to provide the reference for the early nursing intervention with the focus of patients. Methods The convenience sampling method was used to select outpatients with stable COPD from the department of respiratory clinic of a tertiary hospital in Nanning from October 2020 to July 2021. Questionnaires,including a general information questionnaire and the revised version of the Chronic Obstructive Pulmonary Disease Patient Reported Outcome Scale (mCOPD-PRO),were used to collect the results of inflammatory response indicators at the time. Results A total of 204 patients with stable COPD were included,with the mCOPD-PRO score of (1.75±0.58). Multiple regression analysis showed that the factors influencing the patient reported outcomes with stable COPD were gender,the number of comorbidities,disease duration,and lung function grading (P<0.05),which explained 10.8 % of the variance. There were positive correlations between patient reported outcomes with stable COPD and white blood cell count (WBC),neutrophil count (NEU),and eosinophil count (EOS) (P<0.05). There were negative correlations between patient reported outcomes with stable COPD and total albumin (TP) (P<0.05). Conclusion The health level of patients reported outcomes in stable COPD needs to be improved. Female patients,patients with comorbidities>3,longer duration and worse lung function reported lower levels of health. Patient reported outcomes with COPD are closely related to the levels of serum WBC,NEU,EOS and TP. Medical staff should pay more attention to patients reported outcomes and inflammatory indexes in stable COPD,and take targeted intervention measures in the early stage to improve the quality of life of patients.