Elías Hernández M T, Ortega Ruiz F, Sánchez Riera H, Otero Candelera R, Sánchez Gil R, Montemayor Rubio T
Servicio de Neumología, Hospital Universitario Virgen del Rocío, Sevilla.
Arch Bronconeumol. 1999 Jun;35(6):261-6.
To analyze the correlation between quality of life and 1) lung function parameters at rest and during exercise, and 2) mean baseline dyspnea measured on two scales--Mahler's baseline dyspnea index (BDI/TDI) and the Medical Research Council (MRC) scale. We sought to observe the factor or factors having the greatest impact on the quality of life of such patients.
Fifty-five patients diagnosed of COPD in stable phase of disease participated. Al underwent lung function testing at rest and during exercise (shuttle walking test with increasing loads and an exercise cycle test). Quality of life was assessed on the validated Spanish translation of the Chronic Respiratory Disease Questionnaire, which refers specifically to COPD. Baseline dyspnea was measured using Mahler's BDI/TDI and the MRC scale.
Mean patient age was 63 +/- 9.5 years and FEV1 was 40 +/- 16.9%. Overall quality of life and each sub-item correlated significantly with mean dyspnea on both scales (BDI/TDI and MRC). Effort was weakly correlated and function parameters at rest were unrelated. Multiple correlation analysis showed that baseline dyspnea (BDI/TDI) was the most important predictor of quality of life.
Dyspnea, particularly when expressed as BDI/TDI but also as measured on the MRC scale, correlates more highly with quality of life than does any other parameter. This indicates that dyspnea has greater impact than other factor on quality of life and that BDI/TDI provides a good baseline assessment of dyspnea in COPD patients.
分析生活质量与以下两项因素之间的相关性：1）静息和运动时的肺功能参数；2）通过两种量表测得的平均基线呼吸困难程度——马勒基线呼吸困难指数（BDI/TDI）和医学研究委员会（MRC）量表。我们试图观察对这类患者生活质量影响最大的一个或多个因素。
纳入55例诊断为慢性阻塞性肺疾病（COPD）稳定期的患者。所有患者均接受了静息和运动时的肺功能测试（递增负荷往返步行试验和运动周期试验）。使用经过验证的慢性呼吸系统疾病问卷西班牙语译本评估生活质量，该问卷专门针对COPD。使用马勒BDI/TDI和MRC量表测量基线呼吸困难程度。
患者平均年龄为63±9.5岁，第1秒用力呼气容积（FEV1）为40±16.9%。总体生活质量及各子项目与两种量表（BDI/TDI和MRC）测得的平均呼吸困难程度均显著相关。运动能力与之呈弱相关，静息时的功能参数则与之无关。多元相关分析表明，基线呼吸困难程度（BDI/TDI）是生活质量最重要的预测指标。
呼吸困难，尤其是用BDI/TDI表示时，以及用MRC量表测量时，与生活质量的相关性高于任何其他参数。这表明，呼吸困难对生活质量的影响比其他因素更大，并且BDI/TDI为COPD患者的呼吸困难提供了良好的基线评估。
