Zimmermann C S, Carvalho C R F, Silveira K R, Yamaguti W P S, Moderno E V, Salge J M, Kairalla R A, Carvalho C R R
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil.
Braz J Med Biol Res. 2007 Feb;40(2):179-87. doi: 10.1590/s0100-879x2007000200004.
The objective of the present study was to determine if there is a health-related quality of life (HRQL) instrument, generic or specific, that better represents functional capacity dysfunction in idiopathic pulmonary fibrosis (IPF) patients. HRQL was evaluated in 20 IPF patients using generic and specific questionnaires (Medical Outcomes Short Form 36 (SF-36) and Saint George's Respiratory Questionnaire (SGRQ), respectively). Functional status was evaluated by pulmonary function tests, 6-min walking distance test (6MWDT) and dyspnea indexes (baseline dyspnea index) at rest and after exercise (modified Borg scale). There was a restrictive pattern with impairment of diffusion capacity (total lung capacity, TLC = 71.5 +/- 15.6%, forced vital capacity = 70.4 +/- 19.4%, and carbon monoxide diffusing capacity = 41.5 +/- 16.2% of predicted value), a reduction in exercise capacity (6MWDT = 435.6 +/- 95.5 m) and an increase of perceived dyspnea score at rest and during exercise (6 +/- 2.5 and 7.1 +/- 1.3, respectively). Both questionnaires presented correlation with some functional parameters (TLC, forced expiratory volume in 1 s and carbon monoxide diffusing capacity) and the best correlation was with TLC. Almost all of the SGRQ domains presented a strong correlation with functional status, while in SF-36 only physical function and vitality presented a good correlation with functional status. Dyspnea index at rest and 6MWDT also presented a good correlation with HRQL. Our results suggest that a specific instead of a generic questionnaire is a more appropriate instrument for HRQL evaluation in IPF patients and that TLC is the functional parameter showing best correlation with HRQL.
本研究的目的是确定是否存在一种与健康相关的生活质量（HRQL）工具，无论是通用的还是特定的，能更好地体现特发性肺纤维化（IPF）患者的功能能力障碍。使用通用和特定问卷（分别为医学结局简表36（SF - 36）和圣乔治呼吸问卷（SGRQ））对20例IPF患者的HRQL进行了评估。通过肺功能测试、6分钟步行距离测试（6MWDT）以及静息和运动后（改良Borg量表）的呼吸困难指数（基线呼吸困难指数）对功能状态进行评估。存在限制性模式，伴有弥散功能受损（肺总量，TLC = 预测值的71.5 +/- 15.6%，用力肺活量 = 预测值的70.4 +/- 19.4%，一氧化碳弥散量 = 预测值的41.5 +/- 16.2%），运动能力下降（6MWDT = 435.6 +/- 95.5米），静息和运动时主观呼吸困难评分增加（分别为6 +/- 2.5和7.1 +/- 1.3）。两份问卷均与一些功能参数（TLC、第1秒用力呼气量和一氧化碳弥散量）存在相关性，且与TLC的相关性最佳。几乎所有SGRQ领域与功能状态均呈现强相关性，而在SF - 36中只有身体功能和活力与功能状态呈现良好相关性。静息时的呼吸困难指数和6MWDT与HRQL也呈现良好相关性。我们的结果表明，对于IPF患者的HRQL评估，特定问卷而非通用问卷是更合适的工具，且TLC是与HRQL相关性最佳的功能参数。
