内科

目的调查南宁市慢性阻塞性肺疾病（COPD）患者生活质量的现状，分析其城乡差异并比较两群体生活质量的影响因素。方法采用横断面调查设计，于2023年9月至2024年11月，通过方便抽样法选取在南宁市第一人民医院就诊的404例稳定期COPD患者为研究对象。根据长期居住地将患者分为城市组（230例）与农村组（174例）。采用自制一般资料调查表收集人口学及临床资料，使用圣乔治呼吸问卷（SGRQ）评分评估患者的生活质量。采用多元线性回归模型分别分析城乡两组患者生活质量的影响因素。结果南宁市COPD患者SGRQ总分为（15.51±3.20）分，其中症状、活动、影响维度得分分别为（16.17±7.17）分、（12.01±0.35）分、（16.41±2.56）分。城市组患者SGRQ总分［（15.20±3.22）分］低于农村组［（15.91±3.14）分］（P<0.05），且活动维度与影响维度的得分均低于农村组（均P<0.05）。多元线性回归分析结果显示，对于城市COPD患者，家庭氧疗是其SGRQ总分及症状、活动维度得分的影响因素，病程、吸烟是活动维度得分的影响因素，年龄是影响维度得分的影响因素（均P<0.05）；对于农村COPD患者，病程是其SGRQ总分及症状维度得分的影响因素，锻炼习惯是SGRQ总分及症状、影响维度得分的影响因素，年龄是SGRQ总分及活动维度得分的影响因素，合并其他慢性病数量、家庭人均月收入是影响维度得分的影响因素（均P<0.05）。结论南宁市COPD患者的生活质量存在城乡差异，城市患者优于农村患者。影响城乡患者生活质量的因素有所不同：家庭氧疗、病程、吸烟、年龄是南宁市城市COPD患者生活质量的影响因素，病程、锻炼习惯、年龄、合并其他慢性病数量、家庭人均月收入是农村COPD患者生活质量的影响因素。为全面提升患者生活质量，应根据群体特点制定针对性的健康管理干预策略。

Objective To investigate the current status of quality of life in patients with chronic obstructive pulmonary disease (COPD) in Nanning, analyze the urban-rural differences, and compare the influencing factors of quality of life between the two groups. Methods A cross-sectional survey was conducted. From September 2023 to November 2024, 404 patients with stable COPD treated at the First People's Hospital of Nanning were enrolled as research subjects by convenience sampling. According to their long-term residence, they were divided into an urban group (n=230) or a rural group (n=174). A self-designed general information questionnaire was used to collect demographic and clinical data, and the St George's Respiratory Questionnaire (SGRQ) score was applied to evaluate their quality of life. Multiple linear regression models were used to analyze the influencing factors of quality of life in urban and rural groups, respectively. Results The SGRQ total score of COPD patients in Nanning was (15.51±3.20), with scores of (16.17±7.17) for the symptom dimension, (12.01±0.35) for the activity dimension, and (16.41±2.56) for the impact dimension. The SGRQ total score in the urban group (15.20±3.22) was lower than that in the rural group (15.91±3.14) (P<0.05), and the scores of the activity dimension and impact dimension in the urban group were also lower than those in the rural group (all P<0.05). Multivariate linear regression analysis showed that for urban COPD patients, home oxygen therapy was an influencing factor of the SGRQ total score and the scores of symptoms and activity dimensions, disease duration and smoking were influencing factors for the activity dimension score, age was an influencing factor for the impact dimension score (all P<0.05); for rural COPD patients, disease duration was an influencing factor of SGRQ total score and the symptom dimension score, exercise habit was an influencing factor of the SGRQ total score and the scores of symptom and impact dimensions, age was an influencing factor of the SGRQ total score and the activity dimension score, the number of comorbid chronic diseases and per capita monthly household income were influencing factors of the impact dimension score (all P<0.05). Conclusion There are urban-rural differences in the quality of life of COPD patients in Nanning, with urban patients having better quality of life than rural patients. The influencing factors differ between urban and rural patients: home oxygen therapy, disease duration, smoking status, and age affect urban patients' quality of life, while disease duration, exercise habit, age, number of comorbid chronic diseases, and per capita monthly household income affect rural patients'. Targeted health management intervention strategies should be developed according to population characteristic strategies to comprehensively improve patients' quality of life.

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