González Eduardo, Herrejón Alberto, Inchaurraga Ignacio, Blanquer Rafael
Department of Pneumology, Dr. Peset University Hospital, Maestro Valls 46, Pta 21, 46022 Valencia, Valencia, Spain.
Respir Med. 2005 May;99(5):638-44. doi: 10.1016/j.rmed.2004.09.019. Epub 2004 Nov 11.
The aim of our study was to examine the relationship between health-related quality of life (HRQL), lung function parameters and intensity of dyspnea in order to determinate what variables influence the HRQL in patients with pulmonary emphysema.
Forty (mean aged 66+/-9) consecutive male patients with pulmonary emphysema were evaluated. All patients underwent spirometry, measurement of lung volumes, inspiratory and expiratory respiratory pressure (MIP and MEP), measurement of corrected carbon monoxide diffusing capacity (KCO), and 6-min walking test (6MWT). The scale of dyspnea by the baseline dyspnea index (BDI) and British Medical Council Research (MCR), and the quality of life by Chronic Respiratory Question Disease (CRQD) were also assessed.
FEV1, FVC, 6MWT, KCO, MEP, MIP, BDI and MCR were correlated with dimensions of CRQD. Factor analysis reduced these variables to four factors, which accounted for 86.2% of the total variance: (1) airway obstruction, (2) dyspnea, (3) capacity of effort, (4) maximum static respiratory pressure. In the multiple regression model BDI and MEP explained the 64% of the total variance of CRQD.
Quality of life measured by CRQD in patients with emphysema is predominantly determined by dyspnea, and in minor degree by expiratory muscle strength. Our results underscore the usefulness of dyspnea scales and MEP in the evaluation of HRQL in patients with emphysema.
我们研究的目的是检查健康相关生活质量（HRQL）、肺功能参数与呼吸困难强度之间的关系，以确定哪些变量影响肺气肿患者的HRQL。
对40例（平均年龄66±9岁）连续的男性肺气肿患者进行评估。所有患者均接受了肺活量测定、肺容积测量、吸气和呼气呼吸压力（MIP和MEP）测量、校正一氧化碳弥散能力（KCO）测量以及6分钟步行试验（6MWT）。还评估了基线呼吸困难指数（BDI）和英国医学委员会研究（MCR）的呼吸困难量表以及慢性呼吸系统疾病问卷（CRQD）的生活质量。
FEV1、FVC、6MWT、KCO、MEP、MIP、BDI和MCR与CRQD的维度相关。因子分析将这些变量简化为四个因子，占总方差的86.2%：（1）气道阻塞，（2）呼吸困难，（3）用力能力，（4）最大静态呼吸压力。在多元回归模型中，BDI和MEP解释了CRQD总方差的64%。
肺气肿患者通过CRQD测量的生活质量主要由呼吸困难决定，其次由呼气肌力量决定。我们的结果强调了呼吸困难量表和MEP在评估肺气肿患者HRQL方面的有用性。
