Mostert R, Goris A, Weling-Scheepers C, Wouters E F, Schols A M
Asthma Center Hornerheide, Horn, The Netherlands.
Respir Med. 2000 Sep;94(9):859-67. doi: 10.1053/rmed.2000.0829.
The relationship between tissue depletion and decreased exercise performance has been well established in patients with COPD. In this study we investigated the influence of the pattern of tissue depletion on health related quality of life (HRQL) and their mutual relationship with exercise capacity and dyspnoea. Patients with low body weight and/or low fat-free mass (FFM; using bioelectrical impedance) were categorized in three groups according to type of tissue depletion: loss of both FFM and fat mass (FM), and loss of FFM or FM only. Handgrip strength (HGS) was used as a functional outcome measure of tissue depletion. Exercise performance was assessed by 12 min walking distance (12MWD) and dyspnoea by visual analogue scale (VAS). HRQL was measured with the St George's Respiratory Questionnaire (SGRQ) and the Medical Psychological Questionnaire for Lung diseases (MPQL). Patients with depletion of FFM irrespective of body weight showed greater impairment in 12MWD, HGS, the 'activity' and 'impact' scores of the SGRQ and the domain 'invalidity' of the MPQL, in comparison with depleted patients with relative preservation of FFM. Exercise performance and dyspnoea were also significantly related to these subscores of HRQL. In addition, dyspnoea related significantly to the domain 'symptoms' of the SGRQ. Tissue depletion pattern remained significantly related to SGRQ-scores and the domain 'invalidity' of the MPQL when dyspnoea and walking distance were added to the model as a covariates. Tissue depletion is an important determinant of HRQL independent of exercise capacity and dyspnoea.
在慢性阻塞性肺疾病（COPD）患者中，组织消耗与运动能力下降之间的关系已得到充分证实。在本研究中，我们调查了组织消耗模式对健康相关生活质量（HRQL）的影响，以及它们与运动能力和呼吸困难之间的相互关系。体重低和/或无脂肪量（FFM；使用生物电阻抗法测量）低的患者根据组织消耗类型分为三组：FFM和脂肪量（FM）均减少，仅FFM或FM减少。握力（HGS）用作组织消耗的功能结局指标。运动能力通过12分钟步行距离（12MWD）评估，呼吸困难通过视觉模拟量表（VAS）评估。HRQL使用圣乔治呼吸问卷（SGRQ）和肺部疾病医学心理问卷（MPQL）进行测量。与FFM相对保留的消耗患者相比，无论体重如何，FFM消耗的患者在12MWD、HGS、SGRQ的“活动”和“影响”评分以及MPQL的“无效性”领域均表现出更大的损害。运动能力和呼吸困难也与HRQL的这些子评分显著相关。此外，呼吸困难与SGRQ的“症状”领域显著相关。当将呼吸困难和步行距离作为协变量添加到模型中时，组织消耗模式与SGRQ评分和MPQL的“无效性”领域仍显著相关。组织消耗是HRQL的重要决定因素，独立于运动能力和呼吸困难。
