体重指数与COPD患者生存预后关系的回顾性队列研究.doc

体重指数与COPD患者生存预后关系的回顾性队列研究 葛建军 【摘要】 目的 探讨体重指数（BMI）和COPD长期生存率的关系。方法 回顾性分析2007.7.1-2012.6.30期间入住我院的1436例COPD患者中资料完整的1051例。患者死亡时间通过查询死亡登记处和民政部门确定，临床资料通过查阅病历获得。应用log-rank检验比较生存曲线差异，应用Cox比例风险回归模型评价全死因死亡率与BMI等因素的关系。结果 随访期间共有158例（15.0%）患者死亡。与生存组相比，死亡组年龄较大，病程较长，GOLD分级较高，BMI和FEV1较低，有合并症的患者较多，行长期家庭氧疗者较少。经Cox多因素回归分析调整后，与体重过低患者相比，超重患者的死亡率降低了43%。不同BMI患者的生存率曲线具有显著差异，其中以超重组的患者生存率最高，体重过低组的生存率最低。结论 体重指数是评估COPD患者长期预后的一个重要指标，尤其适合于急性加重期患者的长期生存率的判断。 【关键词】慢性阻塞性肺疾病；体重指数；生存率 The retrospective?cohort study of association of body mass index and long-term?survival? in patients with chronic obstructive pulmonary disease GE Jian-jun. Department of Respiratory Medicine, The First People’s Hospital of Linhai, Linhai 317000, China. 【Abstract】Objective To investigate the association of body mass index (BMI) and long-term?survival?in patients with chronic obstructive pulmonary disease (COPD). Methods 1051 patients with completed data among 1436 hospitalized patients due to COPD from 2007.7.1-2012.6.30 were retrospectively analyzed. The patients time of death was determined by querying death registries and civil affairs departments, and clinical datas were obtained from medical records. Log-rank test was used to compare survival curves differences. Cox model of proportional hazards was used to evaluate the relationship between all-cause mortality and BMI. Results 158 patients (15.0%) died in the period of follow-up. Compared with survival group, death group were older and had a longer clinical course, a higher GOLD grade, a lower BMI and FEV1, more paitents with complications and less patients with LTOT. In an adjusted model, overweight patients had 43% less chance of death when compared to patients with low weight. The survival curves across BMI were statistical different. Highest survival was found for overweight patients and lowest survival was found for patients with low weight. Conclusion Body mass index is an important indicator to assess the long-term prognosis in patients with COPD, especiall