中国全科医学Issue(5)：511-516,6.DOI:10.3969/j.issn.1007-9572.2016.05.004
不同评价指标在慢性阻塞性肺疾病患者综合评估中的应用
Application of Different Evaluation Indexes in the Comprehensive Assessment of Patients With Chronic Obstructive Pulmonary Disease
摘要
Abstract
Objective To evaluate the health status,dyspnea and exercise endurance in the patients with chronic obstructive pulmonary disease( COPD)by SGRQ,CCQ,CAT scale,mMRC dyspnea scale,6MWT,and to analyze the correlation between the evaluation results and the percentage of forced expiratory volume in one second in predicted value (FEV1% pred ) and discuss their value in clinical application. Methods From May to October in 2014, a COPD epidemiological investigation project was carried out in Yonghong region and Weicun region in Changzhou by the Department of Respiratory Diseases of the Third Affiliated Hospital of Soochow University. According to inclusion and exclusion criteria,we enrolled 90 COPD patients. SGRQ,CAT scale,mMRC dyspnea scale,CCQ,BODE,6MWT and pulmonary function test were conducted,and comprehensive analysis was made on the correlation among these evaluation systems and between the evaluation systems and the severity of lung airflow limitation. The COPD patients were divided into groups according to gender, age,and whether complications occurred. Results The total score of SGRQ,CAT score,mMRC score,6MWT and BODE of the 90 patients were(21. 9 ± 14. 4),(17. 0 ± 5. 9),(1. 3 ± 1. 2),(390. 7 ± 86. 2)m and(2. 6 ± 1. 7). Patients with different gender,age and smoking history were significantly different in FEV1% pred,CAT score,mMRC score,CCQ score, SGRQ score,6MWT,times of aggregation per year(P ﹥ 0. 05 for all). Patients with complications and the times of aggregation per year≥2 were lower(P ﹤ 0. 05)in FEV1% pred and 6MWT and were higher(P ﹤ 0. 05)in CAT score,mMRC score,CCQ score,SGRQ score and times of aggregation per year than patients without complications and the times of aggregation per year ﹤2. Patients of different GOLD grades were significantly different in BMI,SGRQ score,CAT score,mMRC score,CCQ score, 6MWT and times of aggregation per year(P ﹤ 0. 05 for all). Pulmonary function(FEV1% pred)of the patients were negatively correlated with CAT score,mMRC score,CCQ score,SGRQ score and BODE(r = - 0. 338, - 0. 703, - 0. 529, - 0. 852,- 0. 837;P ﹤ 0. 01)and were positively correlated with PEF,6MWT and BMI(r = 0. 869,0. 572,0. 322;P ﹤ 0. 01). The comprehensive evaluation of the patients by CAT scale and mMRC dyspnea scale showed that the evaluation results of the two scales for high - risk patients were same(Kappa = 0. 438,P ﹤ 0. 001),but the results for low - risk patients were different(P﹤ 0. 05). The evaluation result of CCQ were same with that of CAT scale for low - risk patients(Kappa = 0. 753,P ﹤ 0. 001). Conclusion The four respiratory questionnaires( SGRQ,CAT,mMRC and CCQ),6MWT and BODE are significantly associated with pulmonary function( FEV1% pred),and they could be used as an effective complement to lung function examination and have a certain application value in the clinical management of COPD.关键词
肺疾病,慢性阻塞性/呼吸功能试验/CAT/mMRC/SGRQKey words
Pulmonary disease,chronic obstructive/Respiratory function tests/CAT/mMRC/SGRQ分类
医药卫生引用本文复制引用
杜晓秋,周军,张秋娣..不同评价指标在慢性阻塞性肺疾病患者综合评估中的应用[J].中国全科医学,2016,(5):511-516,6.基金项目
江苏省前瞻性研究专项基金项目 （）
