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新诊断慢性阻塞性肺疾病患者在一年期间通用及疾病特异性健康相关生活质量的变化

Change in generic and disease-specific health-related quality of life during a one-year period in patients with newly detected chronic obstructive pulmonary disease.

作者信息

Tsukino Mitsuhiro, Nishimura Koichi, McKenna Stephen P, Ikeda Akihiko, Hajiro Takashi, Zhang Min, Izumi Takateru

机构信息

Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

出版信息

Respiration. 2002;69(6):513-20. doi: 10.1159/000066456.

Abstract

BACKGROUND

Although the health-related quality of life (HRQoL) in patients with chronic obstructive pulmonary disease (COPD) has been assessed by generic or disease-specific HRQoL measures, the responsiveness of the generic HRQoL measures is generally weak.

OBJECTIVES

To investigate the responses generated by generic and disease-specific HRQoL questionnaires, we prospectively followed the clinical course of patients with newly detected COPD after the initiation of treatment.

METHODS

A prospective, longitudinal study with a 1-year follow-up was designed. The forced expiratory volume in 1 s (FEV(1)), forced vital capacity (FVC), the Nottingham Health Profile (NHP) as a generic HRQoL measure, and the Chronic Respiratory Disease Questionnaire (CRQ) as a disease-specific HRQoL measure were measured at baseline and at 3, 6, and 12 months after the initiation of standard treatment.

RESULTS

Eighty-two patients completed the study. The FEV(1), FVC, and NHP and CRQ scores improved significantly during the first 3 months (p < 0.05). During the last 6 months, although the FEV(1) declined (p < 0.05), the HRQoL assessed by the NHP and CRQ remained elevated. Except for the score on the social isolation section of the NHP at 12 months, all HRQoL scores at 6 and 12 months were significantly improved compared to baseline (p < 0.05).

CONCLUSION

In new patients with COPD, the NHP as well as the CRQ was able to detect changes in the HRQoL associated with effective medical interventions. The influence of the changes in airflow limitation on the HRQoL was weak.

摘要

背景

尽管慢性阻塞性肺疾病(COPD)患者的健康相关生活质量(HRQoL)已通过通用或疾病特异性HRQoL测量方法进行评估,但通用HRQoL测量方法的反应性通常较弱。

目的

为了研究通用和疾病特异性HRQoL问卷所产生的反应,我们在治疗开始后对新诊断的COPD患者的临床病程进行了前瞻性随访。

方法

设计了一项为期1年随访的前瞻性纵向研究。在基线以及标准治疗开始后的3、6和12个月时,测量1秒用力呼气容积(FEV(1))、用力肺活量(FVC)、作为通用HRQoL测量方法的诺丁汉健康量表(NHP)以及作为疾病特异性HRQoL测量方法的慢性呼吸系统疾病问卷(CRQ)。

结果

82名患者完成了研究。在最初3个月内,FEV(1)、FVC、NHP和CRQ评分均显著改善(p < 0.05)。在最后6个月期间,尽管FEV(1)下降(p < 0.05),但通过NHP和CRQ评估的HRQoL仍保持升高。除了12个月时NHP社交隔离部分的评分外,6个月和12个月时所有HRQoL评分与基线相比均显著改善(p < 0.05)。

结论

在新诊断的COPD患者中,NHP以及CRQ能够检测到与有效医疗干预相关的HRQoL变化。气流受限变化对HRQoL的影响较弱。

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