慢性肺源性心脏病患者生命质量与临床客观指标的相关性研究

发布时间：2018-04-26 08:00

本文选题：肺心病 + 生活质量　；参考：《中国全科医学》2017年01期

【摘要】：目的了解慢性肺源性心脏病(CPHD)患者生命质量与临床客观指标的相关性。方法选取2010年1月—2011年3月,昆明医科大学第一附属医院和昆明医科大学第二附属医院呼吸内科收治的急性加重期CPHD患者140例。对患者进行问卷调查,内容包括基本情况和慢性病患者生命质量测定量表体系中的CPHD量表(2版)〔QLICD-CPHD(V2.0)〕,其中QLICD-CPHD(V2.0)包括生理功能(PHD)、心理功能(PSD)、社会功能(SOD)、疾病特异模块(SPD)4个领域。通过查阅病历收集患者的临床客观指标,包括血常规、尿常规、血生化检查、血气分析及肺功能检查等。采用简单相关分析和典型相关分析探讨QLICD-CPHD(V2.0)各领域及量表总得分与临床客观指标的相关性。结果 CPHD患者PHD、PSD、SOD、SPD及总量表的标准化得分分别为(54.5±13.1)、(59.5±16.1)、(63.0±15.5)、(59.0±16.6)、(58.9±12.5)分。简单相关分析结果显示,氯离子、p H与患者PHD得分呈线性正相关,二氧化碳分压(PCO_2)、体温(TEMP)与患者PHD得分呈线性负相关(P0.05);氯离子、红细胞计数与PSD得分呈线性正相关,TEMP与PSD得分呈线性负相关(P0.05);尿比重与SOD得分呈线性负相关,氧分压(PO_2)、第1秒用力呼气末容积与用力肺活量比值(FEV1/FVC)与SOD得分呈线性正相关(P0.05);ALT、AST、总胆红素、氯离子与SPD得分呈线性正相关,TEMP与SPD得分呈线性负相关(P0.05);ALT、钠离子、氯离子与量表总得分呈线性正相关,TEMP与量表总得分呈线性负相关(P0.05)。典型相关分析共获得4对典型变量,其中1对典型变量的典型相关系数r1=0.411,P0.05。典型变量与原变量的相关性分析结果显示,典型变量的相关关系主要表现为钠离子、氯离子与PHD、PSD、SPD得分间的正相关,PCO2、TEMP与PHD、PSD、SPD得分间的负相关。结论 CPHD患者的PHD得分最低,钠离子、氯离子、PCO_2、TEMP与患者生命质量的相关性较高,治疗过程中应重点关注,以提高CPHD患者的生命质量。
[Abstract]:Objective to investigate the correlation between quality of life (QOL) and clinical objective indexes in patients with chronic pulmonary heart disease (CPHD). Methods from January 2010 to March 2011, 140 patients with acute exacerbation of CPHD were treated in the Department of Respiratory Medicine, the first affiliated Hospital of Kunming Medical University and the second affiliated Hospital of Kunming Medical University. A questionnaire survey was conducted on the patients, including the basic situation and the QLICD-CPHDV 2.0 (QLICD-CPHDV 2.0) in the quality of life measurement system of chronic disease patients. The QLICD-CPHDV 2.0) included four fields: physiological function, psychological function, social function, and disease specific module. Objective clinical indexes including blood routine, urine routine, blood biochemical examination, blood gas analysis and pulmonary function examination were collected by consulting medical records. Simple correlation analysis and canonical correlation analysis were used to explore the correlation between the total scores of QLICD-CPHDV 2.0) and clinical objective indexes. Results the standardized scores of CPHD patients were 54.5 卤13.1% and 59.5 卤16.1%, respectively. The scores of SPD and total volume scale were 59.0 卤16.6and 58.9 卤12.5respectively in patients with CPHD. The results of simple correlation analysis showed that there was a linear positive correlation between chloride ion pH and patients' PHD score, and a linear negative correlation between carbon dioxide partial pressure (PCO2P) and body temperature (TEMPP) and PHD score (P 0.05). There was a linear negative correlation between red blood cell count and PSD score and a linear negative correlation between temp and PSD score (P 0.05), and a linear negative correlation between urine specific gravity and SOD score. The ratio of forced expiratory volume to forced vital capacity (FEV1 / FVC-1) was positively correlated with SOD, total bilirubin, chloride ion and SPD score were positively correlated with total bilirubin, Temp and SPD. There was a linear positive correlation between chloride ion and total score of the scale, and there was a linear negative correlation between TEMP and the total score of the scale (P 0.05). A total of 4 pairs of typical variables were obtained by canonical correlation analysis, among which, the canonical correlation coefficient of 1 pair of typical variables was 0.411 (P0.05). The results of correlation analysis between the typical variables and the original variables showed that the correlation between the typical variables was mainly sodium ion, the positive correlation between the chlorine ion and the SPD score of PHDV PSDD and the negative correlation between the scores of PCO2 + TEMP and PHDV PSDN SPD. Conclusion the PHD score of CPHD patients is the lowest, and the correlation between PHD and quality of life of patients with CPHD is high. In order to improve the quality of life of CPHD patients, we should pay more attention during the course of treatment.
【作者单位】：广东医科大学人文与管理学院广东医科大学生命质量与应用心理研究中心;昆明医科大学第一附属医院呼吸内科;广东医科大学附属医院呼吸内科;
【基金】：国家自然科学基金资助项目(30860248、71373058) 广东省科技计划项目(2013B021800074)
【分类号】：R541.5

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