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[慢性阻塞性肺疾病中呼吸困难及生活质量的评估]

[The evaluation of dyspnea and quality of life in COPD].

作者信息

Demir Gizem, Akkoca Oznur, Doğan Ruşina, Saryal Sevgi, Karabiyikoğlu Gülseren

机构信息

Ankara University Faculty of Medicine, Pulmonary Diseases, 06530 Cayyolu, Ankara, Turkey.

出版信息

Tuberk Toraks. 2003;51(4):365-72.

Abstract

Dyspnea defined as an uncomfortable sensation of breathing is the main cause of disability in chronic obstructive pulmonary disease (COPD) patients. There is evidence that the underlying mechanisms of dyspnea are multifactorial. The aim of this study was to investigate these mechanisms causing dyspnea in COPD patients and the relationship between functional parameters, dyspnea scales and quality of life questionnaire. For this purpose 56 patients (11 female, 45 male) were recruited. Pulmonary function tests including airflow rates, lung volumes, maximal respiratory muscle forces, diffusing capacity, breathing pattern, arterial blood gas analyses as well as dyspnea scales MRC, baseline dyspnea index (BDI) and The Saint George Respiratory Questionnaire (SGRQ) were performed. The overall group showed moderate obstructive disease (FEV1%= 59.02 +/- 3.30) and mild hypoxemia with some air trapping (RV/TLC%= 52.00 +/- 2.00). MRC scale did not show any significant correlation with pulmonary function parameters. There was significant positive correlation between BDI and airflow rates, PImax, DLCO and air trapping. Breathing pattern parameters (Ti/Ttot, VT/Ti) also correlated with BDI. There was positive correlation between PaO2 and BDI (p< 0.001). SGRQ scores correlated significantly with FEV1, PImax, RV/TLC and P 0.1. There was also strong correlation between BDI and SGRQ scores. In conclusion, dyspnea is the result of multiple factors such as airflow limitation, decreased respiratory muscle strength, changes breathing pattern, hypoxemia, and air trapping which in turn affects quality of life in patients with COPD.

摘要

呼吸困难被定义为一种呼吸时的不适感,是慢性阻塞性肺疾病(COPD)患者致残的主要原因。有证据表明,呼吸困难的潜在机制是多因素的。本研究的目的是调查导致COPD患者呼吸困难的这些机制,以及功能参数、呼吸困难量表和生活质量问卷之间的关系。为此,招募了56名患者(11名女性,45名男性)。进行了包括气流速率、肺容积、最大呼吸肌力、弥散能力、呼吸模式、动脉血气分析以及呼吸困难量表MRC、基线呼吸困难指数(BDI)和圣乔治呼吸问卷(SGRQ)在内的肺功能测试。总体组显示为中度阻塞性疾病(FEV1% = 59.02 +/- 3.30)和伴有一定气体潴留的轻度低氧血症(RV/TLC% = 52.00 +/- 2.00)。MRC量表与肺功能参数未显示出任何显著相关性。BDI与气流速率、最大吸气压、一氧化碳弥散量(DLCO)和气体潴留之间存在显著正相关。呼吸模式参数(吸气时间/总呼吸时间、潮气量/吸气时间)也与BDI相关。动脉血氧分压(PaO2)与BDI呈正相关(p < 0.001)。SGRQ评分与FEV1、最大吸气压、残气量/肺总量和P0.1显著相关。BDI与SGRQ评分之间也存在很强的相关性。总之,呼吸困难是多种因素的结果,如气流受限、呼吸肌力量下降、呼吸模式改变、低氧血症和气体潴留,这些因素反过来又影响COPD患者的生活质量。

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