中国七省市慢性阻塞性肺疾病患者的生命质量现况调查

目的 评估COPD患者的牛命质量及其影响因素.方法 2002-2004年对北京、上海、广东、辽宁、天津、重庆和陕西等7个地区城乡40岁及以上人群进行COPD横断面调查,对入选的20245人进行问卷调查和肺功能检测,采用12个条目的 简短生命质量量表(SF-12)评估生命质量,支气管舒张试验后FEV1/FVC＜70%者诊断为COPD.SF-12评分经秩转换后采用一般线性模型分析比较各组间的差别.采用多因素逐步线性同归分析方法 分析影响生命质量的因素.结果 与非COPD患者相比,COPD患者的生命质量下降,心理成分评分分别为(56±7)分和(57±6)分,躯体成分评分分别为(46±9)分和(50±6)分,差异均有统计学意义(F值分别为4.442和453.960,P＜0.05和P＜0.01).COPD患者的心理成分评分主要受气促严重程度、体重指数、合并疾病、性别和居住在城乡的影响;COPD患者的躯体成分评分主要受气促严重程度、合并疾病、性别、COPD分级、职业粉尘烟雾暴露史、年龄、文化程度和既往诊断COPD的影响.结论 COPD患者的生命质量下降,并与气促和疾病严重程度、体重指数和合并疾病密切相关.改善气促症状,加强营养支持,减少合并疾病,远离危险因素的暴露可以改善COPD患者的生命质量.

The quality of life of patients with chronic obstructive pulmonary disease and correlated factors

Objective To evaluate the quality of life(QOL)of patients with chronic obstructive pulmonary disease(COPD)and correlated factors.Methods Data of 20 245 patients with COPD were collected from the cross-sectional survey of COPD,which was conducted between 2002 and 2004 in urban and rural areas of Beijing,Shanghai,Guangdong,Liaoning,Tianjin,Chongqing and Shanxi for residents aged over 40 years old.The recruited populations were interviewed with questionnaire and tested for spirometry.The quality of life was assessed with 12-item short-form health survey questionnaire(SF-12).Those with less than 70% of post-bronchodilator FEV./FVC were identified as having COPD.The differences between groups in SF-12 scores converted by rank were compared using general linear model.Stepwise multiple linear regressions were conducted to study the main determinants of QOL.Results Compared to subjects without COPD,those with COPD had impaired QOL(56±7 vs.57±6 in mental component scores,F=4.442,P＜0.05;46±9 vs.50±6 in physical component scores,F=453.960,P＜0.05).Among COPD patients,the mental component score was associated with scores of dyspnea,BMI,comordities,sex and living areas,while the physical component score was associated with scores of dyspnea,severity of COPD,comordities,exposure to dusts/gases/fumes,sex,age,educational level and previous diagnosis of respiratory diseases(all P＜0.05).Conclusions The QOL in patients with COPD was impaired and associated with scores of dyspnea.severity of COPD,comordities and BML Improvement of dyspnea,nutritional support,prevention of comordities and keeping away from risk factors may improve the QOL in COPD patients.