老年肺结核患者生存质量分析

随着科学的进步及人们医疗观念的转变,人们已经不再单单满足于对疾病的治疗及控制,而是更关注生存个体生存质量情况.个体生存质量调查及评估量表,可以从患者个体的生理、心理、社会关系及周围环境这四大领域对其生存质量及影响因素进行分析,从而比较个体的总体生存质量[1].肺结核作为一类对人类健康有严重威胁的慢性疾病,一直以来都是人们关注及研究的热点[2].本文主要分析目前老年肺结核患者的总体生存质量及其影响因素.     

肺结核流动人口社区干预的生存质量评价

目的 用生存质量（Qol)量表测评肺结核流动人口社区干预的效果。方法 采用SF－36，肺TB健康知晓率（KAP）和行为行成率（BIP）表等调查表，对20个干预社区403例流动人口活动性肺TB，进行Qol测量和社区干预前后效果评价，并对Qol的影响因素进行多因素逐步回归分析。结果 社区干预后流动肺TB患者的平均SF－36总评分及生理机能，角色生理状况，心理健康状况，角色心理状况，社会机能，活力,躯体疼痛和主观健康状况的平均评分分别为79，82，62，73，70，75，69，72和80，与干预前（分别为58，68，33，62，35，51，55，50和61）相比，差异有显著性（P＜0．01）；肺结核KAP评分（86与35）和BIP评分（65与42）均大幅提度（P＜0．01）；肺TB流动人口社区干预的主要影响因素有：工作及居住环境，劳动强度，生活方式，营养饮食，健康教育和家庭支持；临床治疗主要影响因素有：疾病的分型，治疗管理模式，药物敏感性，药物的毒副作用，合并其他疾病或感染等。结论 流动肺TB患者社区干预后生存质量全面显著提高，社区干预是有效地控制流动人口肺结核病的必要手段之一，运用Qol测评指导社区干预的规划，实施和效果评价，是一种简便，可行，高效的方法。     

矽肺患者生存质量调查分析

目的评价并分析矽肺患者生存质量状况及其影响因素。方法采用WHOQOL．100量表调查150例矽肺患者及150例未患矽肺工人,将调查结果用sPSs11．0统计软件进行分析。结果矽肺患者生存质量较对照组明显减低,特别是在躯体疼痛、精力、睡眠、信心、负性情感、行动能力、日常生活能力、依赖性、获取信息、休闲活动、信仰,总体健康等方面与未患矽肺工人比较,差异有显著性（P〈0．01或P〈0．05）。矽肺患者并发症的多少、期别的高低、年龄、婚姻状况、参与休闲娱乐的机会及参与程度、人际关系的满意度等对生存质量均有影响。结论在对矽肺及并发症进行治疗的同时,重视健康教育,提供心理治疗,鼓励参加休闲活动和社会交往．有利于提高矽肺患者的生存质量。     

肺结核患者生存质量测量与评价

测量并评价活动性肺结核患的生存质量。方法采用ＳＦ－３６、生存质量指数，ＫＰＳ等量表，对２２８例活动性肺结核患和２２８例正常对照进行ＱｏＬ测量与评价，并与ＱｏＬ的影响因素进行单因素分析和多因素逐步回归分析。     

肺结核患者社会支持与生存质量的相关性研究

肺结核是通过呼吸道传播的慢性传染性疾病。除疾病自身和药物副作用的影响，还有社会对肺结核患者的歧视造成的心理压力．长期治疗带来的经济压力。以及社会功能的下降等因素，均可影响到患者的生存质量。随着医学模式从生物学模式向生物、心理、社会现代医学模式的转变，人们从单纯关注生存数量到全面关心生存质量。     

初治涂阳肺结核患者生活质量调查分析

目的了解肺结核患者在不同的治疗阶段的生活质量状况,提高其的生活质量。方法采用问卷调查方式对2004年9月至2005年2月全市6个区结核病防治机构登记、管治的全部初冶涂阳肺结核患者在确诊后、完成强化期、疗程结束时各一次进行生活质量状况调查。结果初治涂阳肺结核患者诊断为结核病并接受治疗后,健康状况逐步改善,躯体功能、社会功能和心理功能逐步提高。结论随着医学模式由“生物医学”向“生物一心理一社会”模式的转变,更应关注患者的生活质量,加强相关的干预措施。     

复治肺结核患者生存质量及其影响因素的研究

肺结核是一种以呼吸道为主要传播途径的慢性传染性疾病，已成为威胁人类健康的严重疾病之一。治愈的关键是严格的结核化疗，由于耐药、治疗依从性差等原因，部分患者初治失败而进入复治阶段。复治患者病程长、病情和治疗复杂、生理机能减退、心理功能障碍、社会接触减少、工作学习能力下降、业余活动减少，从而影响生存质量。     

老年患者肝脏手术后的生存质量调查

采用GLQI生存质量指标测定12例者年患者和23例非老年患者在接受肝脏手术前后的生存质量情况。结果表明．老年组患者术前平均GLQI生存质量指数为105．5分，与非老年组108.9分相近．术后2w和5w两组患者GLQI指数均明显降低，老年组分别为79．2分和82．0分（P＜0．05），非老年组分别为90．2分和97．6分（P＜0．05），其中老年组较非老年组下降更为明显（P＜0．05），术后10w和16w生存质量逐渐恢复．老年组分别升为94．2分和99．4分（P＞0．05），非老年组分别为101分和106分，仍以老年组显得较低．但在本组小样本系列中．统计学处理已无显著性差异（P＞0．05）。本研究提示老年组患者的生存质量较非老年组更易受肝脏手术的影响。     

高血压病患者生存质量的评价

高血压病是一发病率高的慢性疾患,因而引起全世界卫生工作者的极大关注。如果不进行适当治疗,一些病人可能会发生心、脑、肾等靶器官损害。据估计,在美国,大约有6千万人有血压增高〔BP≥18.7/12kPa(140/90mmHg)〕,尽管轻、中型高血压病人常无症状,但由此引起的心、脑、肾等系统损害有较高的发病率和病死率。大量研究认为,采用适当的措施控制血压于正常水平,可以预防并发症的发生率及死亡率。故近年来,越来越多的轻、中型高血压病人接受各种不同的抗高血压治     

高血压病对患者生存质量的影响

以往医师在治疗高血压时,常常选择对病人说来最为有效的降压药物,并认真调整药物的配伍和剂量以达最佳降压效果,而且还要注意药物对病人代谢方面的影响。尽管在治疗方面如此负责,但却忽略了抗高血压治疗对患者另一方面的影响,即对患者社会活动及工作能力的影响,对患者情绪及嗜好的影响,对患者整个健康状况的影响,如此这些方面也就是对病人生存质量的影响。     

曲美他嗪对慢性肺源性心脏病患者心肺功能及生命质量的影响

目的探讨曲美他嗪对慢性肺源性心脏病(肺心病)患者心肺功能及生命质量(QOL)的影响。方法连续选取2010年9月—2012年3月在武汉市武昌医院呼吸内科住院治疗的慢性肺心病患者96例,将其按随机数字表法分为观察组46例和对照组50例。对照组予以常规治疗,观察组在此基础上加用曲美他嗪,12周为1个疗程。观察两组患者治疗前后第一秒用力呼气容积占用力肺活量百分比(FEV1/FVC)、最大呼气中段流速(MMEF)、血浆氨基末端脑钠肽前体(NT-proBNP)水平及QOL评分。结果治疗后观察组患者FEV1/FVC和MMEF高于对照组,NT-proBNP及QOL评分低于对照组(P0.01)。结论曲美他嗪能改善慢性肺心病患者心肺功能,提高其QOL。     

乙酰半胱氨酸对稳定期慢性阻塞性肺疾病患者急性加重率及生活质量的影响研究

目的观察乙酰半胱氨酸对稳定期慢性阻塞性肺疾病(COPD)患者急性加重率及生活质量的影响。方法选择2012年4月—2013年8月在鄂尔多斯市中心医院门诊就诊的稳定期COPD患者86例,随机分为治疗组43例和对照组43例。对照组给予常规治疗,治疗组在常规治疗的基础上加用乙酰半胱氨酸。观察两组患者肺功能指标、急性加重情况,并采用中文版COPD评估测试(CAT)问卷评价其生活质量。结果两组患者治疗前及治疗后6、12个月第一秒用力呼气容积(FEV1)、FEV1占预计值百分比(FEV1%)、FEV1/用力肺活量(FVC)比较,差异均无统计学意义(P0.05)。治疗前,两组患者中文版CAT问卷总分比较,差异无统计学意义(P0.05);治疗后6、12个月,治疗组患者中文版CAT问卷总分低于对照组,差异均有统计学意义(P0.05)。治疗前及治疗6个月后,两组患者急性加重率比较,差异均无统计学意义(P0.05);治疗12个月后,治疗组急性加重率低于对照组,差异有统计学意义(P0.05)。结论长期口服乙酰半胱氨酸可减少COPD患者急性加重率,改善其生活质量。     

Depression and Health-Related Quality of Life in Chronic Obstructive Pulmonary Disease

Background

Prior research on the risk of depression in chronic obstructive pulmonary disease (COPD) has yielded conflicting results. Furthermore, we have an incomplete understanding of how much depression versus respiratory factors contributes to poor health-related quality of life.

Methods

Among 1202 adults with COPD and 302 demographically matched referents without COPD, depressive symptoms were assessed using the 15-item Geriatric Depression Score. We measured COPD severity using a multifaceted approach, including spirometry, dyspnea, and exercise capacity. We used the Airway Questionnaire 20 and the Physical Component Summary Score to assess respiratory-specific and overall physical quality of life, respectively.

Results

In multivariate analysis adjusting for potential confounders including sociodemographics and all examined comorbidities, COPD subjects were at higher risk for depressive symptoms (Geriatric Depression Score ≥6) than referents (odds ratio [OR] 3.6; 95% confidence interval [CI], 2.1-6.1; P <.001). Stratifying COPD subjects by degree of obstruction on spirometry, all subgroups were at increased risk of depressive symptoms relative to referents (P <.001 for all). In multivariate analysis controlling for COPD severity as well as sociodemographics and comorbidities, depressive symptoms were strongly associated with worse respiratory-specific quality of life (OR 3.6; 95% CI, 2.7-4.8; P <.001) and worse overall physical quality of life (OR 2.4; 95% CI, 1.8-3.2; P <.001).

Conclusions

Patients with COPD are at significantly higher risk of having depressive symptoms than referents. Such symptoms are strongly associated with worse respiratory-specific and overall physical health-related quality of life, even after taking COPD severity into account.     

13例肺结核误诊为肺脓肿分析

目的了解肺结核误诊为肺脓肿的误诊原因。方法回顾性分析13例肺结核患者误诊为肺脓肿的误诊情况。结果 13例中痰凃片检出抗酸杆菌5例,支气管镜刷片及灌洗液检出抗酸杆菌7例,病理及液基细胞学检查符合结核改变者4例。结论对于临床症状、影像学检查表现酷似肺脓肿的肺结核患者,注重病原学及组织学检查是减少误诊关键。     

Impaired Sleep Reduces Quality of Life in Chronic Obstructive Pulmonary Disease

Disturbed sleep is reportedly common in chronic obstructive pulmonary disease (COPD), but the impact of quality of sleep on health-related quality of life (HRQL) has not been previously investigated in these individuals. The purpose of this study was to assess the impact of quality of sleep on HRQL in patients with COPD. In 30 clinically stable patients with moderate to very severe COPD, we evaluated subjective sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and HRQL using the Saint George’s Respiratory Questionnaire. Additionally, lung function was assessed by spirometry, severity of dyspnea by the Modified Medical Research Council scale, and functional exercise capacity by the Six-Minute Walk Test. Twenty-one (70%) patients showed poor quality of sleep (PSQI > 5). HRQL was significantly correlated with quality of sleep (P = 0.02), post-bronchodilator FEV1 (P = 0.04), and severity of dyspnea (P < 0.01). Multiple regression analysis showed that quality of sleep was the best predictor of quality of life in our subjects. Our data suggest that quality of sleep is major determinant of HRQL in COPD. Increased efforts to diagnose and treat sleep problems, including measures to improve factors that adversely affect sleep should receive great attention in the daily management of these patients.     

利福平注射液治疗初治涂阳肺结核的疗效及安全性观察

目的评估利福平注射液与口服利福平治疗初治涂阳肺结核的疗效及安全性。方法选取初治涂阳肺结核患者110例,分为治疗组（I）（INH、舒兰新、PZA、EMB）,对照组（Ⅱ）（INH,RFP,PZA,EMB口服）,分别观察第一个月、第二个月痰菌好转（或阴转）率、x线好转率及药物不良反应。结果第一个月末I、Ⅱ组的痰菌好转（或阴转）率分别为81.7％、20％（P〈0.05）,X线好转率分别为68.3％、20％（P〈0.05）;第二个月痰菌好转（或阴转）率分别为91.7％、88％（P〉0.05）,X线好转率分别为76.7％、64％（P〉0.05）;药物不良反应分别为15％、14％（P〉0.05）,不良反应与利福平口服剂型相同。     

194例结核性胸膜炎合并肺结核病的临床

目的 探讨结核性胸膜炎合并肺结核病的临床及其防治方法。方法 对194例结核性胸膜炎合并肺结核病进行回顾分析。结果 结核性胸膜炎患中合并肺结核病的发生率为23．2％(45／195)；肺内病灶和胸膜炎在同一侧的占53．3％。结论 结核性胸膜炎与肺结核病关系密切，加强初感染结核病早期诊断和治疗，可减少结核性胸膜炎的发病率。     

Quality of Life,Dyspnea, and Functional Exercise Capacity Following a First Episode of Pulmonary Embolism: Results of the ELOPE Cohort Study

Background

We aimed to evaluate health-related quality of life (QOL), dyspnea, and functional exercise capacity during the year following the diagnosis of a first episode of pulmonary embolism.

Gender Differences in Health-Related Quality of Life Among Asthma Patients

Objective. To identify and explain differences between men and women with asthma regarding health-related quality of life (HRQoL). Methods. A cross-sectional study was performed among 967 asthma patients recruited from general practice. Data were collected by means of a pulmonary function assessment, a face-to-face interview, and a written questionnaire. Results. Women with asthma reported lower scores on HRQoL in the age groups 16-34 and 56-75 years but not in the age group 35-55 years. In all age groups, women reported more severe dyspnea but had higher levels of pulmonary function. The poorer HRQoL reported by women could be explained by a more severe dyspnea and a higher level of medication use in women. Conclusions. The finding that women with asthma aged 16-34 and 56-75 years report poorer HRQoL than men is not due to a more severe disease state in terms of pulmonary obstruction but does seem to be related to a more severe subjective disease state in women than in men.     

Gender Differences in Health-Related Quality of Life Among Asthma Patients

Objective.?To identify and explain differences between men and women with asthma regarding health-related quality of life (HRQoL). Methods.?A cross-sectional study was performed among 967 asthma patients recruited from general practice. Data were collected by means of a pulmonary function assessment, a face-to-face interview, and a written questionnaire. Results.?Women with asthma reported lower scores on HRQoL in the age groups 16–34 and 56–75 years but not in the age group 35–55 years. In all age groups, women reported more severe dyspnea but had higher levels of pulmonary function. The poorer HRQoL reported by women could be explained by a more severe dyspnea and a higher level of medication use in women. Conclusions.?The finding that women with asthma aged 16–34 and 56–75 years report poorer HRQoL than men is not due to a more severe disease state in terms of pulmonary obstruction but does seem to be related to a more severe subjective disease state in women than in men.