作者：汪滢，张力，朱艳，谭莉，倪芳

单位：

430014 湖北省武汉市中心医院呼吸内科；通信作者：倪芳，E-mail：hbnifang404@126.com

Units：

Department of Respiratory Medicine，the Central Hospital of Wuhan，Wuhan 430014，China；Corresponding author：NI Fang，E-mail：hbnifang404@126.com

关键词：

慢性阻塞性肺疾病；呼吸困难信念；生活质量；影响因素分析；问卷调查

Keywords：

Chronic obstructive pulmonary disease；Breathlessness Beliefs；Quality of Life；Root cause analysis；Questionnaires

CLC：

R 563.9

DOI：

DOI：10.3969/j.issn.1008-5971.2020.01.010

Funds：

湖北省科技计划项目资助课题（2018CFC815）；武汉市医学科研项目（WZ19C19）

摘要：

目的　探讨慢性阻塞性肺疾病（COPD）患者呼吸困难信念现状及其与生活质量的关系。方法　选取 2017 年 4 月—2018 年 4 月武汉市中心医院呼吸内科收治的 COPD 患者 176 例，采用一般资料调查表、呼吸困难信念问卷（BBQ）、慢性阻塞性肺疾病患者生存质量测评表（COPD-QOL）分别调查患者一般资料、呼吸困难信念现状及生活质量。COPD 患者 BBQ 及其各维度评分与 COPD-QOL 及其各维度评分的相关性分析采用 Pearson 相关分析，COPD 患者 BBQ 评分与 COPD-QOL 评分的关系采用多元线性回归分析。结果　（1）本次调查共发放 176 份调查问卷，有效回收率为 92.05%（162/176）；本组 162 例 COPD 患者 BBQ 评分为（37.14±4.68）分，与北京协和医院 COPD 患者〔BBQ 评分为（36.91±6.87）分〕比较，差异无统计学意义（P>0.05）；COPD-QOL 评分为（104.65±10.11）分。（2）Pearson 相关分析结果显示，COPD 患者恐惧呼吸困难评分、恐惧活动评分及 BBQ 评分与日常生活能力评分、社会活动状况评分、抑郁心理状态评分、焦虑心理状态评分、COPD-QOL 评分均呈正相关（P<0.05）。（3）不同年龄、性别、婚姻状况、医疗费用支付方式、吸烟状况、病程及有无宗教信仰、是否合并其他类型慢性病的 COPD 患者 COPD-QOL评分比较，差异无统计学意义（P>0.05）；不同文化程度、家庭人均月收入、肺功能分级、过去 1 年内因 COPD 住院次数的 COPD 患者 COPD-QOL 评分比较，差异有统计学意义（P<0.05）。（4）多元线性回归分析结果显示，BBQ 评分、文化程度、肺功能分级及过去 1 年内因 COPD 住院次数与 COPD 患者 COPD-QOL 评分独立相关（P<0.05）；拟合的回归方程Y=76.664+0.316X 1 （过去1年内因COPD住院次数）-0.313X 2 （文化程度）+0.286X 3 （肺功能分级）+0.250X 4 （BBQ评分），差异有统计学意义（F=37.249，P<0.01；R 2 =0.487，调整 R 2 =0.474）。结论　COPD 患者呼吸困难信念较强，且呼吸困难信念越强则 COPD 患者生活质量越差。

Abstract：

Objective　To explore the breathlessness beliefs status and its relation to quality of life in patients withchronic obstructive pulmonary disease（COPD）. Methods　From April 2017 to April 2018，a total of 176 patients with COPDwere selected in the Department of Respiratory Medicine，the Central Hospital of Wuhan，general information，dyspnea beliefstatus and quality of life was investigated by the General Information Questionnaire，The Breathlessness Beliefs Questionnaire（BBQ）and COPD-QOL，respectively. Pearson correlation analysis was used to analyze the correlations of BBQ and its eachdimension score with COPD-QOL and its each dimension score in patients with COPD，moreover multiple linear regressionanalysis was used to analyze the relationship between BBQ score and COPD-QOL score in patients with COPD. Results　（1）The effective response rate was 92.05%（162/176）；BBQ score of the 162 patients with COPD was（37.14±4.68），whichwas not statistically significantly different compared with that（36.91±6.87）of COPD patients in Peking Union Medical CollegeHospital（P>0.05）；COPD-QOL score of the 162 patients with COPD was（104.65±10.11）.（2）Pearson correlationanalysis results showed that，fear of dyspnea score，fear of activity score and BBQ score was positively correlated with dailyliving ability score，social activity score，depression score，anxiety score and COPD-QOL score in patients with COPD，respectively（P<0.05）.（3）There was no statistically significant difference in COPD-QOL score in patients with differentage，gender，marital status，payment method of medical expenses，smoking status，course of disease，as well as withreligious belief or not，with other types of chronic diseases or not（P>0.05），while there was statistically significant differencein COPD-QOL score in patients with different education level，family monthly income per person，pulmonary functiongrade and number of hospitalizations due to COPD within the past 1 year，respectively（P<0.05）.（4）Multivariate linearregression analysis results showed that，BBQ score，education level，pulmonary function grade and number of hospitalizationsdue to COPD within the past 1 year were independently related to COPD-QOL score in patients with COPD（P<0.05），withstatistically significant difference in the fitted regression equation（F=37.249，P<0.01；R 2 =0.487，adjusted R 2 =0.474），thatwas Y=76.664+0.316X 1 （number of hospitalizations due to COPD within the 1 past year）-0.313X 2 （education level）+0.286X 3（pulmonary function grade）+0.250X 4 （BBQ score）. Conclusion　Breathlessness beliefs is relatively strong in patients withCOPD，moreover the quality of life is worse and worse as the breathlessness beliefs strengthen.

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