Schelling G, Stoll C, Vogelmeier C, Hummel T, Behr J, Kapfhammer H P, Rothenhäusler H B, Haller M, Durst K, Krauseneck T, Briegel J
Department of Anesthesiology, Klinikum Grosshadern, Ludwig-Maximilians-University, Munich, Germany.
Intensive Care Med. 2000 Sep;26(9):1304-11. doi: 10.1007/s001340051342.
We performed a follow-up cohort analysis in order to delineate the correlation between pulmonary function (PF) and health-related quality of life (HRQL) in patients after ARDS.
Follow-up cohort study.
A 20-bed ICU of a university teaching hospital.
A cohort of 50 long-term survivors of ARDS.
Measurements of PF (FVC, FEV1, TLC, D(LCO)) and HRQL (SF-36 Health Status Questionnaire) were made 5.5 years (median value) after discharge from the ICU. Impairments in PF (defined as PF results below 80% of the predicted value) were frequent but generally mild. Twenty patients had a single PF impairment (with limitations in FEV1/FVC ratio in 12 patients being the most common), four patients had two (with D(LCO) and FEV1/FVC ratio impairment the most common) and three patients had pathologic results in three PF tests (FEV1/FVC ratio, TLC and capillary pO2 during exercise in one case, FVC, TLC and capillary pO2 during exercise in the second patient and FVC, TLC and D(LCO) in the third). Compared to normal controls, survivors of ARDS showed impairments in all SF-36 health dimensions (p < 0.001). Patients with multiple (> 1) PF impairments described the lowest HRQL with major limitations in all SF-36 categories (p < 0.037) including physical and mental summary scores (36.5 vs 46.9, p = 0.037 and 31.3 vs 51.4, p = 0.003) when compared to patients with no or only one PF impairment.
Long-term survivors of ARDS have a significant reduction in HRQL and the presence of multiple PF impairments is associated with maximal decrements in HRQL.
我们进行了一项随访队列分析，以明确急性呼吸窘迫综合征（ARDS）患者肺功能（PF）与健康相关生活质量（HRQL）之间的相关性。
随访队列研究。
一所大学教学医院的20张床位的重症监护病房（ICU）。
一组50例ARDS长期幸存者。
在从ICU出院5.5年（中位值）后，对PF（用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、肺总量（TLC）、一氧化碳弥散量（D(LCO)））和HRQL（SF-36健康状况问卷）进行测量。PF受损（定义为PF结果低于预测值的80%）很常见，但一般较轻。20例患者有单一PF受损（12例患者FEV1/FVC比值受限最为常见），4例患者有两项受损（D(LCO)和FEV1/FVC比值受损最为常见），3例患者三项PF检查结果异常（1例患者为FEV1/FVC比值、TLC和运动时毛细血管血氧分压；第2例患者为FVC、TLC和运动时毛细血管血氧分压；第3例患者为FVC、TLC和D(LCO)）。与正常对照组相比，ARDS幸存者在所有SF-36健康维度上均有受损（p < 0.001）。与无PF受损或仅有一项PF受损的患者相比，有多项（>1项）PF受损的患者HRQL最低，在所有SF-36类别中均有严重受限（p < 0.037），包括身体和精神总结评分（分别为36.5对46.9，p = 0.037；31.3对51.4，p = 0.003）。
ARDS长期幸存者的HRQL显著降低，多项PF受损与HRQL的最大程度下降相关。
