摘要
目的:探讨基于患者报告结局的慢性阻塞性肺疾病(COPD)的潜在风险分层。方法:采用便利抽样法在太原市13家医院抽取474例COPD患者进行问卷调查,以COPD患者报告结局调查问卷中的生理、心理和社会领域部分各维度得分作为外显变量,进行潜在剖面分析(LPA),识别COPD患者潜在风险分层。以生理、心理和社会领域的潜在风险为因变量,以经过单因素筛选的特征为自变量进行Logistic回归分析。结果:经LPA,生理领域有3种潜在风险,474例COPD患者中低特异性(SPE)低独立性(IND)高全身症状(GEN)占比40%,中SPE中IND中GEN占比43%,高SPE高IND低GEN占比17%;已戒烟、职业为工人的患者中SPE中IND中GEN的可能性大于低SPE低IND高GEN,OR(95%CI)为2.909(1.025~8.255)、1.968(1.119~3.460);心理领域支持2种潜在风险,474例中低心理素质占比53%,高心理素质占比47%;无COPD家族史患者心理素质更高,OR(95%CI)为1.871(1.117~3.135)。社会领域支持3种潜在风险,474例中低疾病认知(COG)高疾病对社会活动的影响(INF)高社会支持(SUP)占比44%,中COG中INF中SUP占比26%,高COG低INF低SUP占比30%;知识分子中COG中INF中SUP和高COG低INF低SUP的可能性更大,OR(95%CI)为2.816(1.084~7.316)和3.185(1.131~8.972);农民、工人、管理人员高COG低INF低SUP的可能性更大,OR(95%CI)为2.300(1.156~4.579)、4.092(2.058~8.136)、3.387(1.395~8.220)。结论:本研究分别在生理、心理、社会领域对COPD患者实现了风险分层,为疾病分级管理提供了新依据。
Aim:To explore potential risk stratification of patients with chronic obstructive pulmonary disease(COPD)based on patient-reported outcomes.Methods:A questionnaire survey was conducted on 474 COPD patients from 13 hospitals in Taiyuan city by convenience sampling method.With the scores of physiological,psychological and social domains in the COPD-Patient Reported Outcomes Management as explicit variables,latent profile analysis(LPA)was performed to identify potential risk stratification in COPD patients.Logistic regression analysis was carried out with the potential risks in physiological,psychological and social domains as dependent variables,and the features after single factor screening as independent variables.Results:According to LPA,there were 3 potential risks in the physiological domain.Among 474 COPD patients,low specific symptoms(SPE),low independence(IND),high general symptoms(GEN)accounted for 40%.The proportion of medium SPE,medium IND,medium GEN was 43%,and that of high SPE,high IND,low GEN was 17%.The patients who had quit smoking or were workers were more likely to develop medium SPE,medium IND,medium GEN than low SPE,low IND,high GEN,OR(95%CI)was 2.909(1.025-8.255)and 1.968(1.119-3.460).The psychological domain supported two potential risks.The low mental quality accounted for 53%among 474 cases,and the high mental quality accounted for 47%.Patients without family history of COPD had higher mental quality,OR(95%CI)was 1.871(1.117-3.135).Three potential risks were supported in the social domain.In 474 cases,the low cognition(COG),high influence(INF),high social support(SUP)accounted for 44%,medium COG,medium INF,medium SUP accounted for 26%,and high COG,low INF,low SUP accounted for 30%.The probability of medium COG,medium INF,medium SUP and high COG,low INF,low SUP was higher in intellectuals,OR(95%CI)was 2.816(1.084-7.316)and 3.185(1.131-8.972);farmers,workers and managers were more likely to have high COG,low INF,low SUP,OR(95%CI)was 2.300(1.156-4.579),4.092(2.058-8.136),3.387(1.395-8.220).Conclusion:This study has realized the risk stratification of COPD patients in physiological,psychological and social domains respectively,providing a new basis for disease classification management.
作者
张垚烨
李莉芳
何航帜
姬祎姗
胡象文
张岩波
赵卉
ZHANG Yaoye;LI Lifang;HE Hangzhi;JI Yishan;HU Xiangwen;ZHANG Yanbo;ZHAO Hui(Department of Health Statistics,School of Public Health,Shanxi Medical University,Shanxi Provincial Key Laboratory of Risk Assessment of Major Diseases,Taiyuan 030000;Department of Respiratory and Critical Care Medicine,the Second Hospital,Shanxi Medical University,Taiyuan 030000;School of Health Services and Management,Shanxi University of Traditional Chinese Medicine,Jinzhong,Shanxi 030619)
出处
《郑州大学学报（医学版）》
CAS
北大核心
2024年第3期313-319,共7页
Journal of Zhengzhou University(Medical Sciences)
基金
山西省科技成果转化引导专项(202104021301063)
中央引导地方科技发展专项(YDZX20191400004736)
山西省科技合作交流专项(202204041101031)。
关键词
慢性阻塞性肺疾病
患者报告结局
潜在剖面分析
风险分层
chronic obstructive pulmonary disease
patient reported outcome
latent profile analysis
risk stratification
