Exacerbations worsen the quality of life of chronic obstructive pulmonary disease patients in primary healthcare
Exacerbations worsen the quality of life of chronic obstructive pulmonary disease patients in primary healthcare
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DOI：
10.1111/j.1742-1241.2008.01707.x
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发表时间：
2008-04-01
影响因子：
2.6
通讯作者：
Miravitlles, M.
中科院分区：
文献类型：
--
作者：
Llor, C.;Molina, J.;Miravitlles, M.
目的：调查慢性阻塞性肺疾病 (COPD) 患者生活质量的演变，并量化两年内病情加重对生活质量恶化的影响。方法：在初级保健中进行了为期 2 年的多中心、观察性、前瞻性研究。 COPD 患者每 6 个月就诊一次。记录研究期间发生的所有病情恶化，并使用圣乔治呼吸问卷（SGRQ）测量这些患者的生活质量。结果：27 名医生参与并收集了 136 名患者的信息，患者平均年龄为 70 岁（SD：9.7），平均 1 秒用力呼气量（FEV1）为预测值的 48.7%（SD：14.5%）。研究开始时 SGRQ 的平均全球分数为 39.6，研究结束时为 37.9。没有病情加重的患者平均改善了 -5.32 个单位，而病情加重的患者则平均恶化了 +0.2 个单位 (p = 0.023)。在后者中，只有一次恶化的患者改善了 -3.8 个单位 (p = 0.012)，而两次或多次恶化的患者则恶化了 +2.4 个单位 (p = 0.134)。肺功能保存较好的患者中，病情加重的影响更大，有或无加重的患者中，FEV1 > 50% 的患者 SGRQ 变化分别为 +0.23 和 -6.17 (p = 0.017)，而 FEV1 患者的 SGRQ 变化分别为 +0.18 和 -4.39 (p = 0.32)
Aims: To investigate the evolution of the quality of life of patients with chronic obstructive pulmonary disease (COPD) and quantify the impact of exacerbations on the deterioration of quality of life over 2 years. Methods: Multicentre, observational, prospective 2-year study carried out in primary care. Patients with COPD were seen every 6 months. All the exacerbations developing during the study period were recorded and the quality of life of these patients was measured with the St. George's Respiratory Questionnaire (SGRQ). Results: Twenty-seven physicians participated and collected information on 136 patients with a mean age of 70 years (SD: 9.7) and a mean forced expiratory volume in 1 s (FEV1) of 48.7% predicted (SD: 14.5%). The mean global score of the SGRQ was 39.6 at the beginning of the study and 37.9 at the end. Patients without exacerbations improved an average of -5.32 units compared with a worsening of +0.2 among patients with exacerbations (p = 0.023). Among the latter, patients with only one exacerbation improved -3.8 units (p = 0.012) compared with a worsening of +2.4 in those with two or more exacerbations (p = 0.134). The impact of exacerbations was greater in patients with more preserved pulmonary function, with a change in the SGRQ among patients with or without exacerbations of +0.23 and -6.17 (p = 0.017), respectively in patients with a FEV1 > 50%, vs. +0.18 and -4.39 (p = 0.32) in patients with a FEV1