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目的 评价重症慢性阻塞性肺疾病 (COPD)患者生存时间的影响因素。方法 1993年对 2 0 2例重症COPD患者进行一般情况、血气、肺功能、心电图、肺阻抗容积波图和 6min行走距离等检查 ,并进行 7年 (1993～2 0 0 0年 )随访 ,记录生存状况。采用Cox回归模型进行分析。结果 分析资料发现 :(1)随访 198例 ,随访率98 0 % ,总病死率 2 8 8% ;(2 )回顾性比较 :生存组与死亡组基线年龄、肺功能、血气分析、6min行走距离、肺阻抗容积波图等级、心电图差异有显著性 ;(3)前瞻性单因素分析 :肺型P波、电轴右偏、顺钟向转位组病死率显著高于阴性组 ;(4)Cox生存时间分析 :控制基线年龄、性别、干预与否后 ,肺功能、血气分析、6min行走距离、肺阻抗容积波图等级及心电图检查结果对患者生存时间有显著影响。结论 肺功能、血气分析、6min行走距离、肺阻抗等级和心电图检查结果对COPD患者生存时间有显著影响。
Objective To evaluate the influencing factors of survival time in patients with severe chronic obstructive pulmonary disease (COPD). Methods A total of 202 patients with severe COPD were examined for blood gas, pulmonary function, electrocardiogram, pulmonary impedance volume wave and distance traveled in 6min in 1993. The patients were followed up for 7 years (1993 ~ 2000) and recorded Living conditions. Cox regression model was used for analysis. The results of the analysis of the data found that: (1) follow-up of 198 cases, follow-up rate was 98 0%, the total case fatality rate was 28.8%; (2) retrospective comparison: survival group and death group baseline age, lung function, blood gas analysis, 6min walking distance (3) Prospective univariate analysis showed that the mortality of pulmonary P wave, right deviation axis and clockwise shift group was significantly higher than that of the negative group (4) Cox survival analysis: Lung function, blood gas analysis, distance traveled in 6 minutes, pulmonary impedance wave volume and electrocardiogram were significantly affected by the control of baseline age, sex and intervention. Conclusions Lung function, blood gas analysis, 6min walking distance, lung impedance grade and electrocardiogram have significant effects on the survival time of patients with COPD.