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慢性阻塞性肺疾病患者不同呼吸困难量表的比较

The comparison of different dyspnoea scales in patients with COPD.

作者信息

Ozalevli Sevgi, Ucan Eyup S

机构信息

School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey.

出版信息

J Eval Clin Pract. 2006 Oct;12(5):532-8. doi: 10.1111/j.1365-2753.2006.00658.x.

Abstract

OBJECTIVES

(i) To compare the relationship between different dyspnoea scales and physical and clinical parameters of patients with chronic obstructive pulmonary disease (COPD); and (ii) to determine the most suitable scale among these scales for this patient group.

METHODS

Forty patients with COPD [mean 1st second forced expiratory volume (FEV(1)), 49.16 +/- 2.33% predicted], aged 53-85 participated in this study. The severity of dyspnoea was assessed with different five scales [Modified Borg Scale (MBS), Visual Analogue Scale (VAS), Medical Research Council Dyspnoea Scale (MRCS), Baseline Dyspnoea Index (BDI) and Oxygen Cost Diagram (OCD)]. As clinical parameters, respiratory function was measured by means of pulmonary function test and arterial blood gas analysis. As physical parameters, age and body mass index was recorded.

RESULTS

Patient's dyspnoea severities were 1.59 +/- 2.75, 2.03 +/- 2.82, 2.14 +/- 1.44, 6.81 +/- 4.07, 4.56 +/- 2.47 for MBS, VAS, MRCS, BDI, OCD, respectively (P = 0.08). It was proven that only %FEV(1) had a correlation with MRCS (r = -0.67, P = 0.01) and BDI (r = 0.58, P = 0.02). In addition to these determinations MRCS, MBS and VAS had a strong correlation defining their relationships with each other (P < 0.05).

CONCLUSIONS

MRCS and BDI could assess dyspnoea during daily activities, so these scales showed strength correlation with physical and clinical values. Briefly MRCS is the most suitable dyspnoea scale for the patients with COPD, moreover, BDI, as the second suitable scale, is correlated only with MRCS. Based on these findings, we recommended that MRCS and BDI are appropriate scales for evaluation of dyspnoea in the patients with COPD.

摘要

目的

(i)比较不同呼吸困难量表与慢性阻塞性肺疾病(COPD)患者身体及临床参数之间的关系;(ii)确定这些量表中最适合该患者群体的量表。

方法

40例COPD患者[第1秒用力呼气容积(FEV₁)均值为预计值的49.16±2.33%],年龄53 - 85岁,参与了本研究。采用不同的五种量表[改良Borg量表(MBS)、视觉模拟量表(VAS)、医学研究委员会呼吸困难量表(MRCS)、基线呼吸困难指数(BDI)和氧耗图(OCD)]评估呼吸困难的严重程度。作为临床参数,通过肺功能测试和动脉血气分析测量呼吸功能。作为身体参数,记录年龄和体重指数。

结果

MBS、VAS、MRCS、BDI、OCD的患者呼吸困难严重程度分别为1.59±2.75、2.03±2.82、2.14±1.44、6.81±4.07、4.56±2.47(P = 0.08)。经证实,仅FEV₁%与MRCS(r = -0.67,P = 0.01)和BDI(r = 0.58,P = 0.02)存在相关性。除这些测定外,MRCS、MBS和VAS之间存在强相关性,表明了它们相互之间的关系(P < 0.05)。

结论

MRCS和BDI可评估日常活动中的呼吸困难,因此这些量表与身体和临床值显示出强相关性。简而言之,MRCS是COPD患者最适合的呼吸困难量表,此外,BDI作为第二适合的量表,仅与MRCS相关。基于这些发现,我们建议MRCS和BDI是评估COPD患者呼吸困难的合适量表。

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