Chang J A, Curtis J R, Patrick D L, Raghu G
Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington, Seattle, WA 98195, USA.
Chest. 1999 Nov;116(5):1175-82. doi: 10.1378/chest.116.5.1175.
Health-related quality of life associated with interstitial lung disease has received little attention in clinical studies because there have been no validated methods for directly measuring it. We have assessed the validity of several generic and respiratory-specific quality-of-life instruments in patients with interstitial lung disease.
Cross-sectional study.
Outpatient pulmonary clinic at a university referral center.
Fifty patients with interstitial disease such as idiopathic pulmonary fibrosis, sarcoidosis, hypersensitivity pneumonitis, and asbestosis.
Patients were administered four quality-of-life questionnaires, the Medical Outcomes Study Short Form 36 (SF-36), the Quality of Well-being scale (QWB), the Chronic Respiratory Questionnaire (CRQ), and the St. George's Respiratory Questionnaire (SGRQ). Patients concomitantly underwent pulmonary function testing and performed a 6-min walk.
Validation of these instruments was based on testing an a priori hypothesis that worse quality-of-life scores should correlate with more severe physiologic impairment demonstrated by pulmonary function tests, exercise tolerance on the 6-min walk, and dyspnea scores. Our patients, on average, had a moderate degree of physiologic impairment and demonstrated moderately decreased quality-of-life scores. Scores from all four quality-of-life questionnaires correlated significantly with 6-min walk distance and dyspnea score. Scores from the SF-36, QWB, and SGRQ showed significant correlation with FVC, FEV(1), and diffusing capacity as well. The SF-36 and SGRQ consistently showed the strongest correlation with physical impairment.
Our findings indicate that preexisting quality-of-life instruments can be applied to patients with interstitial lung disease and suggest that the SF-36 and the SGRQ, in particular, are sensitive tools for assessing quality of life in these patients. Future intervention studies of patients with interstitial lung disease should consider using these measures.
与间质性肺疾病相关的健康相关生活质量在临床研究中很少受到关注，因为一直没有经过验证的直接测量方法。我们评估了几种通用的和呼吸系统特异性生活质量工具在间质性肺疾病患者中的有效性。
横断面研究。
大学转诊中心的门诊肺部诊所。
50例患有间质性疾病的患者，如特发性肺纤维化、结节病、过敏性肺炎和石棉沉着病。
患者接受了四份生活质量问卷，即医学结局研究简明健康调查36项量表（SF-36）、幸福感量表（QWB）、慢性呼吸问卷（CRQ）和圣乔治呼吸问卷（SGRQ）。患者同时进行了肺功能测试并进行了6分钟步行试验。
这些工具的验证基于对一个先验假设的测试，即较差的生活质量评分应与肺功能测试、6分钟步行试验中的运动耐量和呼吸困难评分所显示的更严重生理损害相关。我们的患者平均有中度生理损害，生活质量评分中度下降。所有四份生活质量问卷的评分均与6分钟步行距离和呼吸困难评分显著相关。SF-36、QWB和SGRQ的评分也与用力肺活量（FVC）、第1秒用力呼气容积（FEV₁）和弥散能力显著相关。SF-36和SGRQ始终显示与身体损害的相关性最强。
我们的研究结果表明，现有的生活质量工具可应用于间质性肺疾病患者，并表明特别是SF-36和SGRQ是评估这些患者生活质量的敏感工具。未来对间质性肺疾病患者的干预研究应考虑使用这些测量方法。
