• Title/Summary/Keyword: 만성폐쇄성폐질환

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Polymorphisms in the SERPINA1 Gene and the Risk of Chronic Obstructive Pulmonary Disease in a Korean Population (한국인에서 SERPINA1 유전자 다형성과 만성폐쇄성폐질환의 위험도)

  • Cha, Seung-Ick;Choi, Jin Eun;Lee, Jong Myung;Yoo, Seung Soo;Kim, Chang-Ho;Lee, Won Kee;Jung, Tae-Hoon;Kim, Nung Soo;Park, Jae Yong
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.4
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    • pp.285-291
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    • 2008
  • Background: We conducted a case-control study to evaluate the potential association between SERPINA1 genotypes ($M1_{Val}$, $M1_{Ala}$, S, and Z) and the risk COPD. Methods: The study population consisted of 93 patients with COPD and 112 healthy controls. The polymerase chain reaction and restriction fragment length polymorphism for detecting the SERPINA1 variants. Results: The M2 allele of the SERPINA1 gene was significantly associated with the risk of COPD in Koreans. The effect of the M2 allele on the risk of COPD was more pronounced in the subgroup<64 years. Conclusion: These results suggest that SERPINA1 polymorphisms may contribute to a genetic predisposition for COPD. However, additional studies with larger sample sizes are required to confirm our findings.

The Mediating Effects of Resilience between Symptom Experience and Depression in Patients with Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환 환자의 증상경험과 우울의 관계에 미치는 극복력의 매개효과)

  • Kong, Kyoung-Ran;Lee, Eun-Nam
    • Korean Journal of Adult Nursing
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    • v.27 no.4
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    • pp.375-383
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    • 2015
  • Purpose: The purpose of this study was to identify the relationship of resiliency and symptom experience and depression. Subjects (N=152) were patients with chronic obstructive pulmonary disease (COPD).admitted to D University Medical Center in B City. Methods: Data collection was conducted from July 20 to August 25, 2013. The levels of symptom, resilience, and depression were measured using a seven question symptom experience measuring instrument, a 25-question resilience instrument, and a 15-question Short Geriatric Depression Scale (SGDS). The collected data were analyzed by descriptive analysis, Pearson's correlation coefficients, and path analysis using SPSS/Win 19.0 and AMOS 5.0. Results: There was a significant negative correlation between symptom and resilience, a significant positive correlation between symptom and depression, and a significant negative correlation between resilience and depression. Symptom showed a direct effect on depression and an indirect effect on depression scores through resilience as a mediating variable. Conclusion: It is necessary to develop nursing intervention programs to relieve symptom in COPD patients, and to develop appropriate resilience enhancement programs to reduce their depression.

Related Factors of Quality of Life in Male Patients with Chronic Obstructive Pulmonary Disease (남성 만성폐쇄성폐질환자의 삶의 질 관련요인)

  • Lee, Hae-Jung;Jee, Young-Ju
    • Korean Journal of Adult Nursing
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    • v.23 no.4
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    • pp.309-320
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    • 2011
  • Purpose: The purpose of the study was to examine the related factors of quality of life (QOL) among patients with Chronic Obstructive Pulmonary Disease (COPD). Methods: Patients diagnosed with COPD (N=230) were recruited from four hospitals in Kyeong-Nam province, from March 2 to November 30, 2010. The data collection instruments were the Short Form 36, perceived dyspnea measure by Modified Medical Research Council, COPD and Asthma Sleep Impact Scale, COPD Self-efficacy Scale, and Center for Epidemiologic Studies Depression Scale were used. Following the completion of the data collection instruments Pulmonary function was tested. Data were analyzed with descriptive statistics, Pearson correlation and simultaneous multiple regression using SPSS/WIN. Results: The mean QOL of this study was 68.24. Using a multivariate approach, the significant correlates of QOL were depression (${\beta}$=-.37), dyspnea (${\beta}$=-.28), self-efficacy (${\beta}$=.20), and a sufficient degree of household income (${\beta}$=.16). These variables explained 49% of variance in QOL. Conclusion: The study suggests that psychological aspects are an important factor in explaining QOL of the patients. Screening and minimizing depression could be effective strategies in enhancing QOL of patients with COPD and further investigation to reduce depression could warrant the improvement of QOL in patients with COPD.

Factors Influencing Health-related Quality of Life of Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환자의 건강 관련 삶의 질에 영향을 미치는 요인)

  • Kim, Na Hyoun;Park, Jin-Hee
    • Journal of muscle and joint health
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    • v.23 no.3
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    • pp.159-168
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    • 2016
  • Purpose: The purpose of this study was to identify the factors influencing health-related quality of life (HRQOL) of patients with chronic obstructive pulmonary disease (COPD). Methods: A sample of 108 Patients diagnosed with COPD was recruited from outpatients, at a university hospital. Data were collected from February to April in 2016 using the St. George's Respiratory Questionnaire, the Hospital Anxiety-Depression Scale, and the COPD Self-efficacy scale. Results: The average score of HRQOL was 47.56 in patients with COPD. Results of the regression analysis showed that dyspnea phase (${\beta}$=.34, p<.001) and presence or absence of oxygen (${\beta}$=.20, p=.009), anxiety (${\beta}$=.29, p<.001), $FEV_1$ % predicted (${\beta}$=-.15, p=.014) were statistically significant in patients' HRQOL. Conclusion: The research findings show that dyspnea phase and anxiety among psychological factors were the most powerful factors that explain the HRQOL of COPD patients when the demographic and disease characteristics were controlled. Identification of quality of life-related factors should be used to inform targeted interventions, in order to improve HRQOL and help patients' cope.

Development of a Scale to Measure Self-Care for Korean Patients with Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환자의 자가관리측정도구 개발)

  • 전정자;김애경;최상옥;애정희;최미경;장선아
    • Journal of Korean Academy of Nursing
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    • v.33 no.1
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    • pp.9-16
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    • 2003
  • Purpose : The objective of this study was the development and validation of a scale to measure the self-care of patients with chronic obstructive pulmonary disease(COPD) in Korea. Method: Self-care scale was developed based on the self-care activities patients had to carry out in order to manage their COPD. The original scale contained 34 items rated along a five-point Likert scale and was reviewed by 18 professional nurses and 10 Korean patients with COPD for content validity. Subsequently, patients with COPD were asked to complete this 23-item scale and further tests were done with the 125 useable responses. Result: Factor analysis identified eight factors-'maintaining a clean air way', 'taking medication', 'support from family', 'preventing infection', 'managing symptoms', 'breathing exercising', and 'taking in nutrition'. The internal consistency of the total scale was Cronbach's α=0.7226. These eight factors explained 60.8% of total variance. There was correlation among Korean Self-Care Scale score, administration level, and knowledge level but there was no correlation to patients' satisfaction with medical services. Conclusion: The 23 item questionnaire positively identified 8 areas defined important for COPD patients. Further studies are required to see how these can be integrated into patient education.

Effect of N-Acetylcysteine on the Supetoxide Release, Chemotaxis from the Neutrophils and Glutathione Level of Plasma and Neutrophils (N-Acetylcysteine이 호중구의 Superoxide, Chemotaxis 및 혈장과 호중구의 Glutathione에 미치는 영향)

  • Song, Jeong-Sup;Lee, Sook-Young;Moon, Hwa-Sik;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.475-483
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    • 1994
  • Background: N-acetylcysteine(ACE) is used both orally and intravenously in a variety of experimental pathologies resembling human disease states which exhibit endothelial toxicity as a result of oxidative stress, including acute pulmonary oxygen toxicity, septicemia and endotoxin shock. Despite these observations in vivo, it is not certain how this thiol drug produces its protective effects. ACE is a cysteine derivative which is able to direct1y react with oxygen radicals and may also act as a cysteine and glutathione(GSH) precursor following deacetylation. In this paper, we tried to know whether the therapeutic doses of ACE can modify the inflammatory function of the neutrophils and can increase the glutathione level of plasma in chronic obstructive pulmonary disease(COPD) patients. In addition, the effect of ACE to the purified neutrophil in terms of superoxide release and glutathione synthesis were observed. Method: Firstly, we gave 600mg of ACE for seven days and compare the release of superoxide, luminol-enhanced chemiluminescence from the neutrophils, neutrophil chemotaxis, and plasma GSH levels before and after ACE treatment in COPD patients. Secondly, we observed the dose dependent effect of ACE to the purified neutrophil's superoxide release and GSH levels in vitro. Results: 1) Usual oral therapeutic doses(600mg per day) of ACE for seven days did affect neither on the neutrophil's superoxide release, chemiluminescence, chemotaxis, nor on the plasma GSH concentration in the COPD patients. 2) ACE decreases the purified neutrophil's superoxide release and increase the GSH production in dose dependent fashion in vitro. Conclusion: Despite the fact that oral ACE treatment did not affect on the neutrophil's inflammatory function and plasma GSH concentration in COPD patients in usual therapeutic doses, it decreases the superoxide release and increases the GSH production from the isolated neutrophils in high molar concentrations. These findings suggest that to obtain an antioxidative effects of ACE, it might be needed to increase the daily dosage of ACE or therapeutic duration or change the route of adminisration in COPD patients.

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The Study for the Relationship of Weight Loss with Plasma Leptin and TNF-α Level in Patients with Chronic Bronchitis and Emphysema (만성기관지염과 폐기종 환자에서 체중감소와 혈중 Leptin 및 TNF-α와의 관계에 대한 연구)

  • Pack, Jong Hae;Park, Ji Young;Park, Hye Jeong;Baek, Suk Hwan;Shin, Kyeong Cheol;Chung, Jin Hong;Lee, Kwan Ho
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.2
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    • pp.199-209
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    • 2003
  • Background : Unexplained weight loss, which commonly occurs in patients with chronic obstructive pulmonary disease(COPD), is important because weight loss is an independent risk factor of mortality and morbidity in these patients. Leptin is known to play an important role in regulating body weight. In addition, the tumor necrosis factor($TNF-{\alpha}$) might also play a potential role in the weight loss experienced in chronic wasting disease. The aim of this study was to determine the influence of plasma leptin and the circulating $TNF-{\alpha}$ system to the difference in the body compositions in patients with COPD. Methods : Spirometry, body composition analysis and the plasma concentrations of leptin, $TNF-{\alpha}$ and a soluble TNF receptor (STNF-R55, -R75) were measured in 31 patients with chronic bronchitis and 10 patients with emphysema. The COPD subtype was classified by the transfer coefficient of carbon monoxide, DLco/VA. Results : The circulating levels of leptin were significantly lower in those patients with emphysema($108.5{\pm}39.37pg/ml$) than those with chronic bronchitis($180.9{\pm}57.7pg/ml$). The circulating levels of sTNF-R55 were significantly higher in the emphysema patients($920.4{\pm}116.4pg/ml$) than in those with chronic bronchitis($803.2{\pm}80.8pg/ml$). There was no relationship between the circulating leptin levels and the activated TNF system in patients with chronic bronchitis and emphysema. However, the circulating leptin levels correlated well with the BMI and fat mass in both patient groups. Conclusion : These results suggest that the weight loss noted in emphysema patients may be associated with the activation of the $TNF-{\alpha}$ system rather than the plasma leptin level.

Prevalence and Risk Factors of Osteoporosis in Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자에서 골다공증의 유병률과 위험인자)

  • Sim, Yun Su;Lee, Jin Hwa;Ryu, Yon Ju;Chun, Eun Mi;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.3
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    • pp.186-191
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    • 2009
  • Background: Osteoporosis is a significant comorbidity in patients with chronic obstructive pulmonary disease (COPD). This study examined the prevalence and risk factors associated with osteoporosis in patients with COPD. Methods: The bone mineral densities (BMDs) of the lumbar spine and femoral bone were measured in 53 patients with clinically stable COPD and 41 age- and gender-matched control subjects showing a normal lung function. Osteoporosis was defined as a T-score $\leq$-2.5. The subjects' clinical characteristics and laboratory data were reviewed, and multiple logistic regression analysis was used to identify the risk factors associated with osteoporosis in COPD patients. Results: The prevalence of osteoporosis was 47% and 32% in the COPD patients and controls, respectively. In particular, using the femoral neck T-score, the prevalence of osteoporosis in COPD patients was higher than that in the controls (26% vs. 5%; p=0.006). The average T-score of the lumbar spine (p=0.025) and femoral neck of COPD patients were significantly lower than those of the controls (p=0.001). The forced expiratory volume in the 1 second ($FEV_1$) % predicted (p=0.019; odds ratio [OR], 0.955; 95% confidence interval [CI], 0.919-0.993) and age (p=0.024; OR, 1.144; 95% CI, 1.018-1.287) were independently associated with osteoporosis in patients with COPD. Conclusion: Using the femoral neck T-score, the prevalence of osteoporosis in patients with COPD was higher than the age-and gender-matched controls. A lower $FEV_1$ and older age further increase the risk of osteoporosis in patients with COPD.

Effectivenss of Water based Exercise Training in COPD Patients: A Systematic Review and Meta-analysis (만성폐쇄성폐질환자의 수중운동중재 효과: 체계적 문헌고찰 및 메타분석)

  • An, Min-Hee;Kim, Yun-Hee
    • Journal of the Korea Convergence Society
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    • v.12 no.7
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    • pp.93-104
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    • 2021
  • This study has been conducted by a systematic review of literature and a meta-analysis in order to identify the effect of water based exercise training for COPD(Chronic obstructive pulmonary disease). Two researchers selected relevant literature, and extracted the date and assessed the quality of literature. A total of 5 studies met the inclusion criteria, and the outcome of methodological quality of the literature was not positive. According to the result of meta-analysis of water based exercise and usual care, it was considerably effective in 6 MWT and quality of life. This study introduces various types of water based exercise for COPD patients, which is considered useful for application of the program. However, it experiences difficulty to generalize due to lack of the number of literature in relation to the water based excercise.

The Effects of Self-Efficacy Promoting Pulmonary Rehabilitation Program in Out-Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 외래환자에서 자기효능감증진 호흡재활프로그램의 효과)

  • Jung, Jang Hee;Kim, Jung Youp
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.6
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    • pp.533-546
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    • 2006
  • Background: The aim of this study was to determine the effectiveness of self-efficacy promoting pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD). Methods: thirty six patients, with clinically stable COPD were randomly assigned: 18 to a rehabilitation group and another 18 as a control group, The subjects participated in a the self-efficacy promoting pulmonary rehabilitation program for 8 weeks. This program consisted of education, breathing retraining, exercise training, relaxation and counseling. The control group received education only. The outcome variables were self-efficacy, dyspnea, exercise endurance, pulmonary function, and quality of life. Dyspnea was measured using the modified Borg scale. Exercise endurance was measured by the six minute walking distance. The quality of life was measured by the quality of life index for pulmonary disease patients. Results: In the rehabilitation group after performing the self-efficacy promoting pulmonary rehabilitation program, the self-efficacy score, exercise endurance, and quality of life score were higher than the control group (p=0.007, p=0.038, and p=0.039, respectively). and the exertional dyspnea score was significantly lower than controls(p=0.045). However, the dyspnea score and FEV1 were similar after performing the self-efficacy promoting pulmonary rehabilitation program. Conclusion: The self-efficacy promoting pulmonary rehabilitation program is effective to in improve self-efficacy, exertional dyspnea, exercise endurance and quality of life in patients with COPD.