Xuzhou Center for Disease Control and Prevention, 142 West Erhuan Road, Xuzhou City 221006, Jiangsu Province, PR, China.
BMC Public Health. 2013 Jul 2;13:627. doi: 10.1186/1471-2458-13-627.
Patients with chronic obstructive pulmonary disease (COPD) often have organ dysfunction and resulting poor quality of life; however, in China little information is available regarding factors that affect their health. Here, the relationship between risk factors, activities and psychological disorders and health of patients with COPD in rural areas of Xuzhou, China was assessed.
A cross-sectional study of 7597 COPD patients randomly selected by place of residence from 24,641 COPD patients who had been identified by screening of the 1.10 million health records of all residents of the target area was carried out to evaluate the relationships between risk factors, activities, psychological disorders and the ADO index (age, dyspnea, and airflow obstruction). The participants were assessed by spirometry and by administering a newly designed face-to-face questionnaire, which included items on general factors, risk factors, activities and psychological disorders. Correlations between the ADO index and the items addressed by the questionnaire were calculated.
The mean score of the ADO index was 3.7 ± 1.6. The ADO indices of current smokers, ex-smokers, and non-smokers were 3.9 ± 2.1, 3.7 ± 1.9, and 3.2 ± 1.5, respectively (P < 0.001). The ADO indices of cooks and non-cooks were 4.0 ± 2.2 and 3.5 ± 1.7, respectively (P < 0.001). The correlation coefficient between self-assessment of health status and ADO index was 0.976 (P < 0.001). Only 5.7% of patients reported no limitation of their daily living activities. The correlation coefficient between daily living activities and ADO index was 0.981 (P < 0.001). Only 5.5% of patients reported no limitation of social activities. The correlation coefficient between social activities and ADO index was 0.989 (P < 0.001), between the assessed anxiety score and ADO index 0.972 (P < 0.001), and between the assessed depression score and ADO index 0.989 (P < 0.001).
COPD severity was significantly correlated with behavior (especially regarding smoking and cooking with biofuel in confined spaces), physical strength, daily living activities, social activities, anxiety and depression. Comprehensive approaches are required for the prevention and treatment of COPD.
慢性阻塞性肺疾病（COPD）患者常伴有器官功能障碍和生活质量下降；然而，中国对于影响 COPD 患者健康的因素知之甚少。本研究评估了中国徐州农村 COPD 患者的危险因素、活动和心理障碍与健康之间的关系。
采用整群随机抽样方法，对 24641 例 COPD 患者进行调查，共纳入 7597 例 COPD 患者，通过筛查目标地区 110 万居民的健康记录来评估 COPD 患者的危险因素、活动、心理障碍与 ADO 指数（年龄、呼吸困难和气流阻塞）之间的关系。采用肺量计和新设计的面对面问卷评估患者，问卷内容包括一般因素、危险因素、活动和心理障碍。计算 ADO 指数与问卷中各项指标的相关性。
ADO 指数的平均得分为 3.7±1.6。当前吸烟者、曾吸烟者和非吸烟者的 ADO 指数分别为 3.9±2.1、3.7±1.9 和 3.2±1.5（P<0.001）。厨师和非厨师的 ADO 指数分别为 4.0±2.2 和 3.5±1.7（P<0.001）。健康自评与 ADO 指数的相关系数为 0.976（P<0.001）。仅有 5.7%的患者报告日常生活活动不受限制。日常生活活动与 ADO 指数的相关系数为 0.981（P<0.001）。仅有 5.5%的患者报告社会活动不受限制。社会活动与 ADO 指数的相关系数为 0.989（P<0.001），评估的焦虑评分与 ADO 指数的相关系数为 0.972（P<0.001），评估的抑郁评分与 ADO 指数的相关系数为 0.989（P<0.001）。
COPD 严重程度与行为（特别是吸烟和在封闭空间中使用生物燃料做饭）、体力、日常生活活动、社会活动、焦虑和抑郁显著相关。需要采取综合方法预防和治疗 COPD。
