目的：了解上海市普陀区社区慢阻肺患者生存状况。方法病人来源于普陀区长征镇和甘泉社区。评估内容包括一般情况、营养状况、肺功能、6分钟步行距离(6WMT)、呼吸困难量表、生活质量测评、焦虑自评表、抑郁自评表、日常生活活动能力量表。结果79例社区慢阻肺患者平均年龄71．4±8．8岁。男性占80%,其中95．2%为吸烟者。90%首次行肺功能检查,Ⅱ级、Ⅲ级分别占52%和38%。随着肺功能减退,6WMT逐渐缩短。Ⅳ级患者平均BMI为19．2 kg/m2,较另三组明显下降(P<0．05)。Ⅲ级和Ⅳ级患者Borg评分、mMRC评分、日常活动能力评分、生活质量总评分均较Ⅱ级显著升高( P<0．01)；Ⅳ级较Ⅲ级、Ⅱ级Ⅰ级,均无差异(P>0．05)。焦虑及抑郁评分在各组间无统计学差异(P>0．05)。结论肺功能Ⅲ、Ⅳ级患者各项评估指标均显著下降,提示慢阻肺在Ⅱ至Ⅲ级进程是肺功能损害和病情快速进展关键期,故需早诊断、早治疗。%Objective To analyze and evaluate the impact of chronic obstructive pulmonary disease ( COPD) on patients from Putuo District in Shanghai of China. Methods All patients were from the Changzhen and Ganquan community in Putuo district of Shanghai. The participants were assessed by general situation questionnaire, nutrition questionnaire, 6-MWT, dyspnea questionnaire ( mMRC, the Borg scale) , SGRQ, self-rating anxiety scale, self-rating depression scale and activities of daily living scale. Results The mean age of 79 patients with COPD was 71. 4 ± 8. 8 years old. 80% of them was male, and the smoking rate in men was 95. 2%. 90% of these patients were the first time for pulmonary function test. 52% and 38% of the patients had gradeⅡand gradeⅢof COPD respec-tively. The 6 minute walking distance was shorter with the decline of lung function. The mean BMI in grade IV pa-tients was 19. 2 kg/m2, which was significantly lower than the other three groups. The scores of the Borg scale, mMRC, SGRQ and ADL in grade Ⅲ and grade IV patients were significantly higher than grade Ⅱ patients ( P<0. 01). There was no statistical difference in these scores between the grade Ⅲ and IV groups, so did between the grade Ⅱ and I groups (P>0. 05). The scores of SDS and SAS in each group had no difference (P>0. 05). Con-clusion Stage Ⅱis the critical period in the impairment of pulmonary function, which needs early prevention, diag-nosis and treatment.
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