| 周 海,王妍敏,郏 琴,常 晶,杨 玲.不同表型的重度稳定期COPD患者生活质量和营养状况的比较分析[J].,2021,(20):3867-3870 |
| 不同表型的重度稳定期COPD患者生活质量和营养状况的比较分析 |
| Comparative Analysis of Quality of Life and Nutritional Status in Patients with Severe Stable COPD with Different Phenotypes |
| 投稿时间：2021-03-07 修订日期：2021-03-31 |
| DOI：10.13241/j.cnki.pmb.2021.20.013 |
| 中文关键词: 慢性阻塞性肺疾病 慢性支气管炎表型 生活质量 营养状况 |
| 英文关键词: Chronic obstructive pulmonary disease Chronic bronchitis phenotype Quality of life Nutritional status |
| 基金项目:上海交通大学2019年度"技术推广项目"（ZT201903）；上海市科学技术委员会基金项目(18441905200)；上海交通大学中国医院发展研究院医院发展战略研究所项目(HDSI-2020-B-010) |
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| 中文摘要: |
| 摘要 目的：分析不同表型重度稳定期慢性阻塞性肺病(chronic obstructive pulmonary disease，COPD)患者生活质量及营养状况差异以指导临床干预。方法：选取上海市杨浦区市东医院2017年1月至2018年6月呼吸内科门诊重度（Ⅲ级）慢性阻塞性肺病的稳定期患者79例，按照临床表型分为慢性支气管炎表型（chronic bronchitis，CB）组（48例）与非CB组（31例），进行肺功能检查和微型营养评定量表（mini nutritional assessment, MNA）、慢性阻塞性肺病评估量表（COPD Assessment Test, CAT ）、改良英国医学研究委员会呼吸困难评级量表(Modified Medical Research Council Dyspnea, MMRC）、日常生活活动能力量表（Activity of Daily Living Scale, ADL）评分，测量握力和患者6分钟步行距离，进行比较分析。结果：COPD非CB组的MNA评分、CAT评分、ADL评分、mMRC评分均优于CB组（P<0.05），6分钟步行距离也优于CB组（t值为2.256，P<0.05）。CB组MNA评分与FEV1/预计值、FVC、6分钟步行距离、ADL评分、握力存在显著正相关性（r值分别为0.441、0.379、0.442、0.511、0.316，P<0.05），与CAT评分、mMRC评分有显著负相关性（r值分别为-0.385、-0.460，P<0.05）；非CB组MNA评分与CAT评分呈显著负相关性（r值为-0.376，P<0.05），而与FEV1、FVC、6分钟步行距离、mMRC评分、ADL评分无显著相关性（P>0.05）。结论：非CB表型的重度稳定期COPD患者的生活质量、营养状况均优于CB表型患者。CB表型的COPD患者可能需要更多的营养支持以改善患者的生活质量。 |
| 英文摘要: |
| ABSTRACT Objective: To discuss the difference in the quality of life and nutritional status in patients with severe stable chronic obstructive pulmonary disease (COPD) with different phenotypes. Methods: 79 stable patients with severe COPD (grade Ⅲ) from January 2017 to June 2018 in Shidong Hospital of Yangpu District in Shanghai were selected and divided into chronic bronchitis (CB) group (n=48) and non CB group (n=31) according to their clinical phenotypes. The values of pulmonary function, MNA(mini nutritional assessment), CAT(COPD Assessment Test), mMRC(Modified Medical Research Council Dyspnea), ADL(Activity of Daily Living Scale), grip strength and 6-minute walking distance of all patients were collected and analyzed. Results: The values of MNA, CAT, ADL, mMRC in non CB group were better than those in CB group(all P<0.05). And 6-minute walking distance of non CB group is better(t=2.256, P<0.05). In CB group, the value of MNA was positively correlated with FEV1 / predicted value, FVC, 6-minute walking distance, ADL and grip strength (r=0.441, 0.379, 0.442, 0.511, 0.316, all P<0.05), but negatively correlated with CAT and mMRC (r=-0.385, -0.460, all P<0.05). In non CB group, the value of MNA was only negatively correlated with CAT(r=-0.376, P<0.05), but was not correlated with FEV1, FVC, 6-minute walking distance, mMRC and ADL(P>0.05). Conclusion: The quality of life and nutritional status of patients in non CB group with severe stable COPD are better than those in CB group. It suggests that COPD patients with CB phenotype may need more nutritional support to improve their quality of life. |
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