Corlateanu Alexandru, Botnaru Victor, Covantev Serghei, Dumitru Silvia, Siafakas Nikolaos
Department of Respiratory Medicine, State University of Medicine and Pharmacy 'Nicolae Testemitanu', Chisinau, Republic of Moldova.
Respiration. 2016;92(4):229-234. doi: 10.1159/000448625. Epub 2016 Sep 15.
Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity in the elderly population. COPD leads to a reduced health-related quality of life (HRQL), but the factors which contribute to this are not well understood. A better understanding of the factors which determine HRQL should lead to an improved care for such patients.
The purpose of this study was to investigate possible age-related differences in HRQL in a population of patients with a similar severity of obstruction.
A total of 180 consecutive COPD patients were enrolled into the study. We analyzed spirometric data, BODE index and its components, and comorbidities were assessed by the Charlson index. HRQL was assessed by the Clinical COPD Questionnaire (CCQ) and St. George's Respiratory Questionnaire (SGRQ).
The cohort consisted of 93 'younger' patients (mean age 54.8 ± 3.1 years) and 87 older patients (mean age 73.1 ± 5.5 years). Patients in both groups had a similar severity of obstruction: FEV1 (% from predicted) was 39.9 ± 13.2% in the elderly group compared to 41.7 ± 11.7% in the younger group (p > 0.05). The forward stepwise regression analysis shows that the BODE index, the Charlson index, and the rate of exacerbations are important predictors of deterioration of HRQL in elderly COPD patients, which explains 29% of the total SGRQ score. In the younger COPD patients, the coefficient of determination R2 was 0.27, but the predictors were the BODE index and the rate of exacerbations.
The BODE index, the Charlson index, and the rate of exacerbations were found to be the major determinants of HRQL in elderly COPD patients, while in younger COPD patients, the BODE index and the rate of exacerbations were influential factors.
慢性阻塞性肺疾病（COPD）是老年人群发病的主要原因。COPD导致健康相关生活质量（HRQL）下降，但导致这种情况的因素尚不清楚。更好地了解决定HRQL的因素应能改善对此类患者的护理。
本研究的目的是调查在阻塞严重程度相似的患者群体中，HRQL可能存在的年龄相关差异。
共有180例连续的COPD患者纳入本研究。我们分析了肺功能数据、BODE指数及其组成部分，并通过Charlson指数评估合并症。HRQL通过临床COPD问卷（CCQ）和圣乔治呼吸问卷（SGRQ）进行评估。
该队列包括93例“年轻”患者（平均年龄54.8±3.1岁）和87例老年患者（平均年龄73.1±5.5岁）。两组患者的阻塞严重程度相似：老年组的第一秒用力呼气容积（占预计值百分比）为39.9±13.2%，而年轻组为41.7±11.7%（p>0.05）。向前逐步回归分析表明，BODE指数、Charlson指数和急性加重率是老年COPD患者HRQL恶化的重要预测因素，这解释了SGRQ总分的29%。在年轻的COPD患者中，决定系数R2为0.27，预测因素为BODE指数和急性加重率。
发现BODE指数、Charlson指数和急性加重率是老年COPD患者HRQL的主要决定因素，而在年轻的COPD患者中，BODE指数和急性加重率是影响因素。
