摘要
目的测定和评价慢性阻塞性肺病(COPD)急性加重患者的生活质量和潜在危险因素的发生率及其影响。方法研究两家大型医院因COPD急性加重入院的196个中重度COPD患者。在患者出院时和出院后1月稳定状态,测量肺功能指标、精神状态及用圣乔治呼吸问卷测定生活质量,并收集了患者的临床性状、社会性状和照料因素。结果196例患者中,吸烟、抑郁及嗜用镇痛剂、安眠药相当普遍,而完成肺康复、接种流感病毒疫苗和肺炎球菌疫苗以及看护支持却很少。生活质量的症状域均值为55.9,活动域均值为65,影响域均值为32.9,总体均值为46.5。多变量分析显示慢性黏液高分泌症、男性、抑郁、前1年多次入院和治疗依顺性差与症状域值低下独立显著相关;前1年多次入院、抑郁、严重气促和72岁以上老年与活动域值低下独立显著相关;抑郁、前1年多次入院、严重气促、病程长和重度吸烟与影响域值低下独立显著相关;抑郁、前1年多次入院、严重气促和病程长与总体数值低下独立显著相关(P<0.05)。结论COPD急性加重患者的生活质量低下与COPD严重程度、患者精神抑郁状态及照料这些可改善因素有关。
ObjectiveTo measure the quality of life(QOL) in patients with acute exacerbation of COPD (AECO(PD) and) the frequency of potential risk factors, and to evaluate the association of risk factors with poor QOL in patients with AECOPD.MethodsA study sample of 196 patients with moderate to severe COPD admitted for acute exacerbations to two large general hospitals were studied. The St George QOL (SGQOL) scale, socio-demographic, clinical and patient care characteristics, including depression and spirometry were ascertained in the stable state before discharge and at one-month post discharge.ResultsThere was a high prevalence of current or ex-heavy smokers, depression and consumption of psychotropic drugs, and low prevalence of care giver support, pulmonary rehabilitation and vaccination. The mean scores for the different domains were 55.9 for symptoms; 65.1 for activity; 32.9 for impact; and the mean of overall total scores was 46.5. Multiple regression analysis showed that CMH, male, depression, previous frequent hospital readmissions and poor therapy compliance were independently related to worse Symptoms Scores. Previous frequent readmissions, depression, severe dyspnea and older age (>72 years) were related to worse Activity Scores of SGQOL. Depression, previous frequent readmissions, severe dyspnea, long COPD duration(5years) and severe smoking were related to worse Impact Scores of SGQOL. Depression, previous frequent readmissions, severe dyspnea and long COPD duration(5years) were independently related to worse Total Scores of SGQOL.Conclusion(Poor QOL) in patients with COPD exacerbation is associated with severity of the disease, as well as psychosocial and health care factors which are modifiable.
出处
《上海第二医科大学学报》
CSCD
北大核心
2005年第7期722-726,共5页
Acta Universitatis Medicinalis Secondae Shanghai
关键词
慢性阻塞性肺病
急性加重
生活质量
危险因素
<Keyword>chronic obstructive pulmonary disease
exacerbation
quality of life
risk factors
