Kupryś-Lipińska Izabela, Kuna Piotr
Pneumonol Alergol Pol. 2014;82(2):82-95. doi: 10.5603/PiAP.2014.0014.
Chronic Obstructive Pulmonary Disease (COPD) is one of the most common chronic diseases of adults and is a major cause of chronic morbidity and mortality throughout the world. It is the cause of physical and mental suffering for the patient, significantly impairs quality of life, reduces the vital activity and affects the patient's life in its various aspects. In 2012, the nationwide survey was conducted in COPD outpatients with a history of smoking exploring the various factors of the disease and its effects on the health and life of the patient. The purpose of the analysis presented here is to assess the impact of COPD and tobacco smoking on the patient's health and life.
Data were collected from patients by their physicians during routine visit with usage of specifically prepared questionnaire for this study. Patients over 35 years of age, with diagnosed COPD, current or past smokers were recruited from outpatients settings. The study involved 10,365 patients with COPD. Representative sample of 2,967 questionnaires were randomly drawn for the statistical analysis.
The mean age of responders was 61.15 ± 10.25 years, 33.98% of participants were women, 56.73% were current smokers and 43.37% declared smoking in the past. The largest number of patients had COPD in a moderate degree (II - acc. to GOLD 2010) - 55.38%, sequentially mild (I) - 21.40%, and severe (III) - 19.96%, the smallest group were people with very severe degree of disease (IV) - 3.27%. Using the new classification of the COPD severity (acc. to GOLD 2013), the largest group of patients were less symptomatic (mMRC ) subjects who had a low risk (A) - 52.67%, but in fact a second group of patients were subjects with severe symptoms and a high risk (D) - 20 45% , sequentially - patients with low severity of symptoms, but a high risk (C) - 16.16% , and severe symptoms and a low risk - 10.72% (B). Patients most often reported that COPD affects their activity in sport (83.45% of respondents), than in living activity (82.78%) and family life (79.3%). COPD had significant (moderate or severe) effect on sport (60.85%) and life activity (38.44%), as well as on work (34.9%), but the greatest impact, leading up to the resignation of the activity: on sport practice (21.75%), sexual intercourse (12.6%) and hobbies (11.49%). The disease severity (GOLD 2013 C/D) was the independent factor which reduced all forms of activity. In patients' opinion smoking had negative impact on their health (52,65%) and the family budget (41.83%). The negative impact of smoking on family relations was declared by 16.38% of respondents. Among the factors which favor effective quit from addiction were: age ≥ 65 years and more seere degree of obturation (III/IV GOLD 2010).
The results of the study confirmed the significant impact of the disease and addiction to smoking not only on patients' life but also on their families.
慢性阻塞性肺疾病（COPD）是成年人中最常见的慢性疾病之一，是全球慢性发病和死亡的主要原因。它给患者带来身心痛苦，严重损害生活质量，降低生命活力，并在各个方面影响患者的生活。2012年，针对有吸烟史的COPD门诊患者开展了一项全国性调查，探究该疾病的各种因素及其对患者健康和生活的影响。此处所呈现分析的目的是评估COPD和吸烟对患者健康和生活的影响。
在患者常规就诊期间，医生使用为本研究专门编制的问卷收集数据。从门诊患者中招募年龄超过35岁、已确诊COPD、目前或曾经吸烟的患者。该研究纳入了10365例COPD患者。随机抽取2967份问卷作为代表性样本进行统计分析。
应答者的平均年龄为61.15±10.25岁，33.98%的参与者为女性，56.73%为目前吸烟者，43.37%宣称过去吸烟。大多数患者患有中度COPD（根据2010年慢性阻塞性肺疾病全球倡议[GOLD]为II级）——55.38%，其次是轻度（I级）——21.40%，重度（III级）——19.96%，疾病程度非常严重（IV级）的患者组最小——3.27%。根据COPD严重程度的新分类（根据2013年GOLD），最大的患者组是症状较轻（改良英国医学研究委员会问卷[mMRC]）且风险较低（A组）的患者——52.67%，但实际上第二组患者是症状严重且风险较高（D组）的患者——20.45%，依次为症状严重程度较低但风险较高（C组）的患者——16.16%，以及症状严重但风险较低（B组）的患者——10.72%。患者最常报告COPD对其体育活动的影响（83.45%的受访者），其次是日常生活活动（82.78%）和家庭生活（79.3%）。COPD对体育活动（60.85%）、日常生活活动（38.44%）以及工作（34.9%）有显著（中度或重度）影响，但影响最大、导致活动放弃的是：体育锻炼（21.75%）、性交（12.6%）和爱好（11.49%）。疾病严重程度（2013年GOLD C/D级）是降低所有活动形式的独立因素。在患者看来，吸烟对他们的健康有负面影响（52.65%），对家庭预算有负面影响（41.83%）。16.38%的受访者宣称吸烟对家庭关系有负面影响。有利于有效戒除烟瘾的因素包括：年龄≥65岁以及阻塞程度更严重（2010年GOLD III/IV级）。
研究结果证实该疾病和吸烟成瘾不仅对患者生活，而且对其家庭都有重大影响。
