慢性阻塞性肺疾病患者肺气肿改变对气道重塑与气流受限相关性的影响

  目的   了解慢性阻塞性肺疾病患者体力活动水平与并发症患病的关系，为减少慢性阻塞性肺疾病并发症提供参考依据。   方法   于2016年9月 — 2017年9月采用分层随机抽样方法在贵州省贵阳市公共卫生救治中心3个院区抽取330例住院慢性阻塞性肺疾病患者进行问卷调查，分析慢性阻塞性肺疾病患者体力活动水平与并发症患病的关系。   结果   本次最终有效调查的315例慢性阻塞性肺疾病患者中，低强度活动水平49例（15.56 %），中强度活动水平178例（56.51 %），高强度活动水平88例（27.94 %）；患有并发症者204例，并发症患病率为64.76 %，其中感染、心血管疾病、慢性肾衰竭、认知功能障碍、代谢综合征、骨质疏松、骨骼肌障碍和肺癌等并发症的患病率分别为28.25 %、11.75 %、11.11 %、11.11 %、11.11 %、7.30 %、6.03 %和3.49 %。204例患并发症慢性阻塞性肺疾病患者中，患1种并发症者56例（27.45 %），患2种并发症者61例（29.90 %），患 ≥ 3种并发症者87例（42.65 %）。在调整了性别、年龄、文化程度、婚姻状况、在职状况、居住地、吸烟情况、饮酒情况、病程、肺功能分级、是否疲劳、是否焦虑和是否抑郁等混杂因素后，多因素非条件logistic回归分析结果显示，中强度活动水平慢性阻塞性肺疾病患者并发症患病风险为低强度活动水平慢性阻塞性肺疾病患者的0.486倍（OR = 0.486，95 % CI = 0.243～0.973），高强度活动水平慢性阻塞性肺疾病患者并发症患病风险为低强度活动水平慢性阻塞性肺疾病患者的0.368倍（OR = 0.368，95 % CI = 0.151～0.897）。   结论   慢性阻塞性肺疾病患者并发症患病类型多样，其中以感染和心血管疾病居多；体力活动强度越大的患者，其并发症患病风险越低。

The prevalence and risk factors of functional dyspepsia in a multiethnic population in the United States

  Objective  To investigate the association of physical activity intensity with complication prevalence among patients with chronic obstructive pulmonary disease (COPD).   Methods  From September 2016 to September 2017, we conducted a survey among 330 COPD inpatients recruited with stratified random sampling in Guiyang public health treatment center. A self-designed questionnaire, International Physical Activity Questionnaire (IPAQ), Fatigue Severity Scale-9 (FSS-9), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI) were used in the survey. The inpatients′ lung function were assessed based on the criteria in Global Initiative for Chronic Obstructive Lung Disease (GOLD).   Results  Of the 315 inpatients completing the survey, 49 (15.56%), 178 (56.51%), and 88 (27.94%) were assessed having low, moderate, and high intensity of physical activity. Among the inpatients, 204 (64.76%) were diagnosed with various complications, and the complication prevalence was 28.25% for infection, 11.75% for cardiovascular disease, 11.11% for chronic renal failure, 11.11% for cognitive dysfunction, 11.11% for metabolic syndrome, 7.30% for osteoporosis, 6.03% for skeletal muscle disorders, and 3.49% for lung cancer, respectively. For all the inpatients with complications, 56 (27.45%), 61 (29.90%), and 87 (42.65%) had one, two, and three or more complications. Unconditional multivariate logistic regression analyses showed that compared to those with low physical activity intensity, the inpatients with moderate and high physical activity intensity were at a significantly decreased risk of having complications, with the odds ratios of 0.486 (95% confidence interval [95% CI]: 0.243 – 0.973) and 0.368 (95% CI: 0.151 – 0.897) after adjusting for potential confounding factors as gender, age, education, marital status, employment, residence, smoking, alcohol drinking, course of disease, lung function, fatigue, anxiety, and depression.   Conclusion  Multiple complications, especially infections and cardiovascular diseases, are prevalent among patients with chronic obstructive pulmonary disease and the intensity of physical activity may inversely correlates with complication prevalence in the patients.