北京市某社区老年慢性阻塞性肺疾病患者健康相关生活质量及影响因素的调查

目的了解老年慢性阻塞性肺疾病（COPD）患者的健康相关生活质量状况，并探讨其影响因素。方法采用简明健康调查量表（SF-36）中文版对北京市100例稳定期老年COPD患者进行调查，并用多元线性逐步回归方法对老年COPD患者健康相关生活质量的影响因素进行分析。结果老年COPD患者SF-36量表8个维度得分均低于天津城区老年人。影响患者健康相关生活质量的因素在生理功能维度为：日常生活活动能力、运动能力、焦虑状况；生理职能维度为焦虑状况、1年内住院次数、体质指数；躯体疼痛维度为焦虑状况；总体健康维度为抑郁状况、社会支持、合并慢性疾病数、运动能力、疾病严重程度；活力维度为抑郁状况；社会功能维度为日常生活活动能力、运动能力、社会支持、抑郁状况；精神健康维度为抑郁及焦虑状况、体质指数；情感职能维度没有变量回归进入。这些影响因素能解释各维度变异的26．6％～66．5％不等。结论北京市某社区老年COPD患者的健康相关生活质量低于一般老年人群，并受多种因素的影响，最主要的影响因素是心理状况和运动能力，应重点进行健康干预，以促进其牛活质量的提高。

Investigation of health-related quality of life and impact factors in elderly patients with COPD in Beijing

Objective To assess the health-related quality of life ( HRQoL) of elderly patients with COPD in Beijing and to explore the impact factors. Methods 100 outpatients diagnosed with irreversible COPD in Beijing completed the SF-36 questionnaire. The scores of 8 dimensions of questionnaire in elderly patients with COPD were calculated and compared with those of the rural general elderly people in Tianjin. Multiple regression analysis was applied to determine the impact factors of different dimensions of SF-36. Results The scores of all the dimensions in the patients were significantly lower than those in general old rural people of Tianjin. The correlations between the different dimensions of the SF-36 and variables were: Physical functioning was well correlated with ADL, ability to carrying activities (6MWD) and anxiety. Role-physical was well correlated with anxiety, admission times in a year and nutrition ( BMI). Body pain was well correlated with anxiety. General health was well correlated with depression, social support, the number of combination chronic disease, ability to carrying activities (6MWD) and the severity of disease (FEV1. 0%). Vitality was well correlated with depression. Social functioning was well correlated with ADL, carrying activities (6MWD), social support and depression. Mental heath was well correlated with depression ,anxiety and nutrition (BMI).No variable showed significant correlation with the Role-emotional dimension. Conclusions The HRQoL of elderly patients with COPD is declined compared with general elderly people. There are a range of factors that impact different dimensions of HRQoL, chiefly emotional status and carrying activities. Targeted measures of health interventions could be carried out to improve the HRQoL of elderly patients with COPD.