稳定型缺血性心脏病合并慢性阻塞性肺疾病患者的生活质量参数

Life quality parameters in patients with combination of stable ischemic heart disease and chronic obstructive pulmonary disease.

作者信息

Rasputina Lesia V, Didenko Daria V, Ovcharuk Maria V

机构信息

National Pirogov Memorial Medical University, Vinnytsia, Ukraine.

出版信息

Wiad Lek. 2018;71(8):1560-1565.

PMID:30684341

Abstract

OBJECTIVE

Introduction: The part of patients with comorbide pathology, which includes ischemic heart disease (IHD) and chronic obstructive pulmonary disease (COPD), increases among patients aged 40 and older. Combination of diseases has a great influence on patients' quality of life (QOL). The aim of the work was investigation of features of QOL parameters in patients with combination of stable IHD and COPD.

PATIENTS AND METHODS

Materials and methods: 272 patients have been studied; they have been divided into three groups: group I included 98 patients with combination of stable IHD and COPD, the average age 65.8±0.83 years, group II - 96 patients with stable IHD, the average age 58.9±0.9; group III consisted of 78 patients with COPD without IHD, the average age 57.9±0.85 years. Typical clinical examination, 6-minute walking test (6 MWT) and evaluation of QOL parameters with health survey questionnaire MOS SF 36 have been conducted.

RESULTS

Results: Patients with combination of stable IHD and COPD have decreased all life quality indices in comparison with patients of groups II and III: physical health in group I was 33.5 points, mental health - 27.5, general health - 50.3 points. QOL parameters in group I corelate with the doctor's visit rate and the number of, hospitalizations and emergency calls. Significantly lower exercise tolerance (distance 336.8±40.8 m per 6 minutes) has been established in group I, as well as marked dyspnea (р=0,003), tachycardia (р=0,017) and a tendency towards blood pressure decrease during exercises (р=0,013).

CONCLUSION

Conclusions: Combination of IHD and COPD is accompanied by worsening of QOL parameters, which should be estimated in clinical practice. Combination of IHD and COPD is associated with requirement of hospital treatment (5.2 times in 5 years) and emergency aid (once a year), that distinguish such patients from patients with isolated IHD or COPD. Patients with combined diseases often need outpatient care, 70.4% - more than 3 times per year.

摘要

目的

引言：40岁及以上患者中，患有包括缺血性心脏病（IHD）和慢性阻塞性肺疾病（COPD）在内的合并症的患者比例有所增加。疾病的合并对患者的生活质量（QOL）有很大影响。本研究的目的是调查稳定型IHD和COPD合并症患者的QOL参数特征。

患者与方法

材料与方法：共研究了272例患者；他们被分为三组：第一组包括98例稳定型IHD和COPD合并症患者，平均年龄65.8±0.83岁，第二组 - 96例稳定型IHD患者，平均年龄58.9±0.9岁；第三组由78例无IHD的COPD患者组成，平均年龄57.9±0.85岁。进行了典型的临床检查、6分钟步行试验（6MWT）以及使用健康调查问卷MOS SF 36对QOL参数进行评估。

结果

结果：与第二组和第三组患者相比，稳定型IHD和COPD合并症患者的所有生活质量指标均下降：第一组的身体健康评分为33.5分，心理健康为27.5分，总体健康为50.3分。第一组的QOL参数与就诊率、住院次数和急诊次数相关。第一组患者的运动耐量明显较低（每6分钟距离为336.8±40.8米），同时存在明显的呼吸困难（р=0.003）、心动过速（р=0.017）以及运动期间血压下降的趋势（р=0.013）。