Katsura Hideki, Yamada Kouichi, Kida Kozui
Pulmonary Division, Tokyo Metropolitan Geriatric Medical Center, 35-2 Sekae-Cho, Itabashi, Tokyo, 173-0015 Japan.
Respir Med. 2005 May;99(5):624-30. doi: 10.1016/j.rmed.2004.09.017. Epub 2004 Dec 13.
This study evaluated the effects of body weight on both generic and disease-specific health-related quality of life (HRQoL) of patients with COPD. A total of 83 patients with stable COPD were enrolled (mean age: 74.6 yr, mean FEV1: 1.29 L). Patients were divided into two groups according to body mass index (BMI) (UW group: BMI < or = 20, NW group: 20 < BMI < or = 26). The degree of dyspnea and both disease-specific and generic HRQoL were compared between the two groups. An oxygen cost diagram (OCD) was used to assess the degree of dyspnea and St. George's Respiratory Questionnaire (SGRQ) and Medical Outcomes Study Short Form 36-item Questionnaire (SF-36) were used for HRQoL evaluation. The OCD was significantly lower in the UW group. Compared with the NW group, the UW group showed significant deterioration in the total score and three subscales of SGRQ. SF-36 also showed significantly worse scores for the parameters of physical functioning, role emotional, bodily pain, and general health. The results of stepwise multiple regression analysis showed that OCD, FEV1, %pred. BMI were independent variables in the total score on SGRQ. The results of stepwise multiple regression analysis also showed that OCD was an independent variable for four of eight components of SF-36, while BMI was three of eight components of SF-36. In conclusion, low body weight in patients with COPD is related to a worsening of dyspnea and deterioration of both generic and disease-specific HRQoL. The present results also indicate that nutritional intervention may be important for improving dyspnea and HRQoL in patients with COPD.
本研究评估了体重对慢性阻塞性肺疾病(COPD)患者一般健康相关生活质量(HRQoL)和疾病特异性健康相关生活质量的影响。共纳入83例稳定期COPD患者(平均年龄:74.6岁,平均第一秒用力呼气容积:1.29L)。根据体重指数(BMI)将患者分为两组(体重过轻组:BMI≤20,正常体重组:20<BMI≤26)。比较两组之间的呼吸困难程度以及疾病特异性和一般HRQoL。采用氧耗图(OCD)评估呼吸困难程度,采用圣乔治呼吸问卷(SGRQ)和医学结局研究简明健康调查问卷(SF-36)评估HRQoL。体重过轻组的OCD显著更低。与正常体重组相比,体重过轻组的SGRQ总分及三个子量表显示出显著恶化。SF-36在身体功能、角色情感、身体疼痛和总体健康参数方面的得分也显著更差。逐步多元回归分析结果显示,OCD、第一秒用力呼气容积、预计值百分比、BMI是SGRQ总分的独立变量。逐步多元回归分析结果还显示,OCD是SF-36八个组成部分中四个部分的独立变量,而BMI是SF-36八个组成部分中三个部分的独立变量。总之,COPD患者体重过轻与呼吸困难加重以及一般和疾病特异性HRQoL恶化有关。目前的结果还表明,营养干预对于改善COPD患者的呼吸困难和HRQoL可能很重要。