Katsura Hideki, Yamada Kouichi, Wakabayashi Ritsuko, Kida Kozui
Division of Respiratory Medicine, Tokyo Women's Medical University, Yachiyo Medical Center, Tokyo, Japan.
Respirology. 2007 May;12(3):427-32. doi: 10.1111/j.1440-1843.2007.01075.x.
Recent studies have reported several gender-associated differences among patients with COPD, but gender-associated differences in health-related quality of life (HRQoL) in patients with COPD have not yet been clarified. This study evaluated gender differences in dyspnoea and HRQoL in patients with COPD.
Study participants were 156 patients with COPD (men 117, women 39); men were individually matched to women by age and FEV(1)% predicted to give a ratio of 3:1 (male : female). Study participants were evaluated for dyspnoea and completed HRQoL questionnaires. An oxygen cost diagram (OCD) was used to assess the degree of dyspnoea and Morale Scale was used to assess subjective well-being. St. George's Respiratory Questionnaire (SGRQ) and SF-36 were used for HRQoL evaluation. The findings in the male and female groups were compared.
The OCD and Morale Scale showed significantly lower values for female patients with COPD. Disease-specific HRQoL assessed by SGRQ was significantly worse, except for symptoms, in female patients with COPD. Generic HRQoL assessed by SF-36 was also significantly worse, except for general health and social functioning. Stepwise multiple regression showed OCD, Morale Scale and 6-min walking distance to be significantly associated with total SGRQ score in the male group, and Morale Scale and 6-min walking distance were significant associations in the female group.
Gender differences exist in dyspnoea and HRQoL in patients with COPD. These need to be considered when designing treatment strategies for COPD patients.
近期研究报告了慢性阻塞性肺疾病（COPD）患者中存在的一些性别相关差异，但COPD患者健康相关生活质量（HRQoL）的性别相关差异尚未明确。本研究评估了COPD患者在呼吸困难和HRQoL方面的性别差异。
研究参与者为156例COPD患者（男性117例，女性39例）；男性按年龄和预测的第1秒用力呼气容积（FEV₁）%与女性进行个体匹配，使男女比例为3:1。对研究参与者进行呼吸困难评估并完成HRQoL问卷调查。使用氧耗图（OCD）评估呼吸困难程度，使用士气量表评估主观幸福感。使用圣乔治呼吸问卷（SGRQ）和SF-36进行HRQoL评估。比较男性和女性组的研究结果。
OCD和士气量表显示COPD女性患者的值显著更低。除症状外，SGRQ评估的疾病特异性HRQoL在COPD女性患者中显著更差。除总体健康和社会功能外，SF-36评估的一般HRQoL在女性患者中也显著更差。逐步多元回归显示，OCD、士气量表和6分钟步行距离与男性组的SGRQ总分显著相关，而士气量表和6分钟步行距离在女性组中具有显著相关性。
COPD患者在呼吸困难和HRQoL方面存在性别差异。在为COPD患者设计治疗策略时需要考虑这些差异。
