Xiang Ping-chao, Yao Zhen, Cheng Xian-sheng, Zhang Er-ming, Zhang Xin, Song Li-ping, Ju Li-xin, Ding Yan, Zhang Ying
Department of Respiratory Medicine, Peking University Shougang Hospital, Beijing 100041, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2006 Sep;29(9):583-6.
To investigate the prognosis of moderate chronic obstructive pulmonary disease (COPD) in the elderly patients, and to evaluate the factors for long term survival.
From May 1993, a prospective cohort study was carried out, in which 191 elderly patients with moderate COPD were recruited in Shougang communities, Shijingshan District, Beijing. The general health state, arterial blood gas, pulmonary function test, electrocardiograph, chest X-ray and 6-minute-walk test (6MWT) were recorded. The patients were followed for 12 years. Univariate analysis of survival rate was performed by Kaplan-Meier method. The significance test was done by Log-rank method, and the baseline factors were analyzed using the COX regression model multiplicity.
During the 12 years of follow-up, 10 patients were lost because of migration. Twenty-six patients died of non-COPD diseases, while 52 died of COPD. The survival rate was 81.7% (156/191) in 5 years, and 56.9% (103/181) in 12 years. The result with COX multiplicity showed that the important factors for prognosis of the patients were body mass index [BMI, relative risk (RR) = 0.916, 95% confidence intervals (95% CI) = 0.841 - 0.996], forced expired volume in one second (FEV(1), RR = 0.999, 95% CI = 0.998 - 1.000), arterial partial pressure of oxygen (PaO(2), RR = 0.929, 95% CI = 0.892 - 0.967), 6MWT (RR = 0.997, 95% CI = 0.995 - 1.000) and P pulmonale of ECG (RR = 4.081, 95% CI = 1.567 - 10.624).
The important factors for prognosis of moderate COPD in elderly patients included BMI, FEV(1), PaO(2), 6MWT and P pulmonale in ECG.
探讨老年中度慢性阻塞性肺疾病（COPD）患者的预后，并评估长期生存的影响因素。
自1993年5月起，开展一项前瞻性队列研究，在北京石景山区首钢社区招募了191例老年中度COPD患者。记录其一般健康状况、动脉血气、肺功能测试、心电图、胸部X线及6分钟步行试验（6MWT）结果。对患者进行了12年的随访。采用Kaplan-Meier法进行生存率的单因素分析。用Log-rank法进行显著性检验，并使用COX回归模型多元分析基线因素。
在12年的随访期间，10例患者因迁移失访。26例患者死于非COPD疾病，52例死于COPD。5年生存率为81.7%（156/191），12年生存率为56.9%（103/181）。COX多元分析结果显示，患者预后的重要影响因素为体重指数[BMI，相对危险度（RR）=0.916，95%可信区间（95%CI）=0.841 - 0.996]、一秒用力呼气容积（FEV₁，RR = 0.999，95%CI = 0.998 - 1.000）、动脉血氧分压（PaO₂，RR = 0.929，95%CI = 0.892 - 0.967）、6MWT（RR = 0.997，95%CI = 0.995 - 1.000）及心电图肺型P波（RR = 4.081，95%CI = 1.567 - 10.624）。
老年中度COPD患者预后的重要影响因素包括BMI、FEV₁、PaO₂、6MWT及心电图肺型P波。
