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目的探讨稳定期慢性阻塞性肺疾病(COPD)患者BODE指数与预后的相关性,为利用BODE指数预测COPD患者的预后提供依据。方法选择2013年10月至2014年10月在广东省中医院大学城院区呼吸内科治疗后出院的稳定期中重度COPD患者66例进行观察性研究,测定所有患者入组时的肺功能、6 min步行距离(6MWD)、呼吸困难程度、体重指数(BMI),按BODE指数评分标准进行评分分级。出院一年后,使用圣乔治呼吸问卷(SGRQ)评分表评价患者生活质量;记录出院一年内患者就诊次数、住院次数、住院天数、呼吸衰竭发生次数、机械通气次数、住院费用和死亡数;用Spearman相关分析方法分析BODE指数与患者预后的相关性。结果入组前BODE指数越高,一年后患者SGRQ各项评分越高,一年内患者就诊次数、住院天数、呼吸衰竭次数、机械通气次数、费用、死亡发生人数亦越多,差异具有显著统计学意义(P<0.01);Pearson相关分析显示,BODE指数与SGRQ总分及机械通气次数、住院费用呈高度正相关(r=1.24,P<0.01;r=1.2,P<0.01;r=1.62,P<0.01),同就诊次数及死亡人数呈较高程度正相关(r=0.85,P<0.01;r=0.44,P<0.01),同住院次数、住院天数及呼吸衰竭次数呈弱相关性(r=0.33,P<0.01;r=0.15,P<0.01;r=0.12,P<0.05)。结论 BODE指数和SGRQ问卷存在良好的相关性,其对稳定期中重度COPD患者生活质量下降及未来一年内发生的就医情况有较好的预测价值。
Objective To investigate the relationship between BODE index and prognosis in patients with chronic obstructive pulmonary disease (COPD) in stable phase and provide the basis for predicting the prognosis of patients with chronic obstructive pulmonary disease by BODE index. Methods Sixty-six patients with stable-to-moderate-to-severe COPD discharged after respiration medical treatment in the University City Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine from October 2013 to October 2014 were selected for observational study. All patients were enrolled in the study. Walking distance (6MWD), degree of dyspnea, body mass index (BMI), according to BODE index grading scale. One year after discharge, the SGQQ was used to evaluate the quality of life of the patients. The number of visits, number of hospitalizations, days of hospitalization, number of respiratory failure, number of mechanical ventilation, hospitalization costs and deaths within one year after discharge were recorded. Spearman correlation analysis analysis of BODE index and the prognosis of patients. Results The higher the BODE index before enrollment, the higher the SGRQ score of patients one year later. The number of visits, length of stay, number of respiratory failure, number of mechanical ventilation, cost and death in one year was also higher, with significant difference (P <0.01). Pearson correlation analysis showed that there was a positive correlation between BODE index and SGRQ total score, mechanical ventilation frequency and hospitalization cost (r = 1.24, P <0.01; r = 1.2, P <0.01; r = 1.62 , P <0.01). It was positively correlated with the number of visits and deaths (r = 0.85, P <0.01; r = 0.44, P <0.01) (r = 0.33, P <0.01; r = 0.15, P <0.01; r = 0.12, P <0.05). Conclusion There is a good correlation between the BODE index and the SGRQ questionnaire, which has a good predictive value for the quality of life of stable COPD patients with moderate to severe COPD and the medical conditions occurring in the next one year.