摘要
目的探讨慢性阻塞性肺疾病(COPD)患者不同时期进行肺康复治疗的时间依从性差异及其影响因素。方法连续选取2013年6月—2015年5月天津市胸科医院呼吸与危重症科因COPD急性加重住院患者,最终到达观察终点304例,随机分为稳定期康复组(178例)及急性加重期康复组(126例);根据所有患者实际完成康复时间是否大于计划康复时间的70%判定依从性,并据此分为依从性好组(115例)及依从性差组(189例)。分别比较稳定期康复组及急性加重期康复组实际完成康复时间、达到依从性好的患者比例及退出率,比较依从性好组及依从性差组的一般临床资料,在肺康复结束后,采用Logistic回归分析影响肺康复依从性的因素。结果稳定期康复组实际完成康复时间、达到依从性好的患者比例均高于急性加重期康复组[(5 641.5±1 080.1)min vs.(4 426.5±1 046.8)min,46.7%vs.25.4%)],稳定期康复组退出率10.6%(21/199)低于急性加重期康复组的退出率26.7%(46/172);依从性好的患者家庭月收入水平、6分钟内步行距离(6MWD)高于依从性差组,年龄、吸烟者比例、呼吸困难评分(MRC评分)及COPD评估测量(CAT)评分低于依从性差组(均P<0.05)。Logistic回归分析结果显示年龄大、吸烟、MRC评分高、CAT评分高是肺康复依从性差的危险因素,月收入≥3 000元、6MWD长是保护因素。结论 COPD患者整体肺康复时间依从性较差,年龄低、不吸烟、收入水平高、生活质量及健康状况好的患者肺康复时间依从性佳。
Objective To explore the differences and infection factors of adherence of pulmonary rehabilitation (PR) in patients with different periods of chronic obstructive pulmonary disease (COPD). Methods The 304 patients were randomly distributed into two groups, stable COPD with PR group (n=178) and acute exacerbation COPD (AECOPD) with PR group (n=126). The course of PR was 12 weeks. According to the adherence definition (practical time of accompolish PR programm>70%of that planned time), patients were divided into good adherence group (n=115) and bad adherence group (n=189). The practical-perform time of PR, proportion of good adherence and PR quitting were compared between two groups. Basic data were collected and analyzed in two groups of patients. After the pulmonary rehabilitation, binary Logistic regression was used to analyse the compliance of pulmonary rehabilitation. Results The practical-perform time of PR and the proportion of good adherence were significantly higher in stable COPD with PR group than those of AECOPD with PR group (5 641.5±1 080.1 min vs. 4 426.5± 1 046.8 min,46.7%vs. 25.4%). The PR quitting proportion (10.6%, 21/199) was significantly lower in stable COPD with PR group than that of AECOPD with PR group (26.7%, 46/172). Compared with AECOPD PR group, the income level and 6 minutes walking distance (MWD) were significantly higher in stable COPD PR group, and the everage age, proportion of tabacco-exposed, MRC score and CAT score were significantly lower in stable COPD group (P<0.05). Logistic regression analysis showed that older-age, tabacco-exposed, higher MRC score and CAT score were risk factors for PR adherence, while the higher income level (≥3 000 yuan) and longer 6MWD were protective factors for PR time-adherence in patients with COPD (P<0.05). Conclusion The time adherence of COPD patients, who undergo pulmonary rehabilitation, is disappointing, especially post-exacerbation. Good adherence would be expected in younger age, non tabacco-exposed, higher income level and better healt
出处
《天津医药》
CAS
2016年第7期917-920,共4页
Tianjin Medical Journal
基金
天津科技支撑计划项目(13ZCZDSY02000)
