Martínez-García Miguel Angel, Perpiñá-Tordera Miguel, Román-Sánchez Pilar, Soler-Cataluña Juan José
Pneumology Unit, La Fe University Hospital, Valencia, Spain.
Chest. 2005 Aug;128(2):739-45. doi: 10.1378/chest.128.2.739.
To determine the most important variables influencing health-related quality of life (HRQL) in patients with clinically stable bronchiectasis (SB).
Cross-sectional study.
A total of 86 patients (mean age, 69.5 years; SD, 8.9 years; 64% male) with SB were included. Data were collected on general patient characteristics, symptoms, laboratory findings, the extent of bronchiectasis, functional variables, medication in acute or stable phases, and the number of exacerbations. All patients completed the St. George Respiratory Questionnaire (SGRQ). Univariate and multivariate analyses were performed to identify the variables significantly influencing HRQL in these patients.
Different clinical parameters (sputum, dyspnea, cough, and wheezing), spirometric variables, and laboratory parameters (fibrinogen), as well as the extent of bronchiectasis, medication, and the number of exacerbations were significantly correlated to the total questionnaire score, although only dyspnea (r2 = 0.43, p < 0.0001), FEV1 (r2 = 0.33, p < 0.0001), and daily sputum production (r2 = 0.2, p < 0.004) were independently correlated to the total score, globally explaining 55% of the total score variability. Systemic steroid treatment of exacerbations (r2 = 0.17, p < 0.028) and the habitual presence of coughing (r2 = 0.22, p < 0.004) and wheezing (r2 = 0.16, p < 0.013) were in turn independently correlated to the activity and symptoms subscales, respectively.
Dyspnea, FEV1, and sputum production are the strongest conditioning factors of HRQL in patients with clinically SB.
确定影响临床稳定期支气管扩张症(SB)患者健康相关生活质量(HRQL)的最重要变量。
横断面研究。
共纳入86例SB患者(平均年龄69.5岁;标准差8.9岁;64%为男性)。收集了患者的一般特征、症状、实验室检查结果、支气管扩张程度、功能变量、急性或稳定期用药情况以及急性加重次数等数据。所有患者均完成圣乔治呼吸问卷(SGRQ)。进行单因素和多因素分析以确定显著影响这些患者HRQL的变量。
不同的临床参数(痰液、呼吸困难、咳嗽和喘息)、肺功能变量和实验室参数(纤维蛋白原),以及支气管扩张程度、用药情况和急性加重次数与问卷总分显著相关,尽管只有呼吸困难(r2 = 0.43,p < 0.0001)、第一秒用力呼气容积(FEV1)(r2 = 0.33,p < 0.0001)和每日痰液生成量(r2 = 0.2,p < 0.004)与总分独立相关,总体解释了总分变异的55%。急性加重期的全身类固醇治疗(r2 = 0.17,p < 0.028)以及习惯性咳嗽(r2 = 0.22,p < 0.004)和喘息(r2 = 0.16,p < 0.013)分别与活动和症状子量表独立相关。
呼吸困难、FEV1和痰液生成是临床稳定期SB患者HRQL的最强影响因素。