目的 了解社区老年慢性阻塞性肺部疾病(COPD)女性患者生活质量,研究营养状况对生活质量评分的影响.方法 选取2014年1月至2017年1月经内蒙古医科大学附属医院诊断的314例社区COPD老年妇女以微型营养评定法(MNA)行营养评定并进行分组,营养良好组164例,营养一般组73例,营养缺乏组77例,比较三组肺功能分级、6min步行及圣乔治问卷生活质量评分差异.结果 不同营养COPD患者FEV1/FVC、FEV1比较有显著性差异(F值分别为34.144、43.646,均P<0.05),进一步每两组之间比较发现,营养良好组患者FEV1/FVC、FEV1均显著高于营养一般组、营养缺乏组(t值分别为3.457、4.021、5.236、5.897,均P<0.05),营养一般组患者FEV1/FVC、FEV1均显著高于营养缺乏组(t值分别为3.034、2.908,均P<0.05).不同营养COPD患者肺功能分级有显著性差异(χ2=70.244,P<0.05),随着营养状况的下降,肺功能分级也处于下降趋势.不同营养COPD患者Borg评分、mMRC评分、步行距离比较有显著性差异(F值分别为7.929、4.198、8.386,均P<0.05),随着营养状况的下降,Borg评分、mMRC评分呈上升趋势,而步行距离呈下降趋势.不同营养COPD患者生活质量中症状评分、活动评分、心理社会评分、总评分比较有显著性差异(F值分别为11.677、6.757、9.240、8.862,均P<0.05),随着营养状况的下降,各评分项目均呈上升趋势.结论 慢性阻塞性肺部疾病患者的营养状况与患者的生活质量关系密切.%Objective To understand the quality of life of community elderly women with chronic obstructive pulmonary disease (COPD) and to study the effect of nutritional status on quality of life score.Methods Altogether 314 cases of female patients with senile COPD in community received nutrition assessment using Mini Nutritional Assessment (MNA) and were divided into groups.There were 164 cases in good nutrition group, 73 cases in general nutrition group and 77 cases in poor nutrition group.Grade of pulmonary function, 6min walking and scores in St George's questionnaire (SGRQ) were compared among three groups.Results There was significant difference in FEV1/FVC, FEV1 of patients with COPD among different groups (F value was 34.144 and 43.646, respectively, both P<0.05).Further comparison between every two groups showed FEV1/FVC and FEV1 of patients in good nutrition group were significantly higher than those in general nutrition and poor nutrition group (t value was 3.457, 4.021, 5.236 and 5.897, respectively, all P<0.05).FEV1/FVC and FEV1 in general nutrition group were significantly higher than those in poor nutrition group (t value was 3.034 and 2.908, respectively, both P<0.05).Difference in lung function grading of COPD patients among different nutrition groups was significant (χ2=70.244, P<0.05), and grading of lung function decreased as nutritional status decreased.There were significant differences in Borg score, mMRC score and walking distance of COPD patients among different nutrition groups (F value was 7.929, 4.198 and 8.386, respectively, all P<0.05).With decline of nutritional status, Borg score and mMRC score rose but walking distance declined.Difference in symptoms score, activity score, psychological and social score and total score in quality of life scaling was significant among COPD patients in different nutrition groups (F value was 11.677, 6.757, 9.240 and 8.862, respectively, all P<0.05).With decline of nutritional status, score of each projects showed upward trend.Conclusion Nutritional status of patients with COPD is closely associated with their quality of life.
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