Karoli N A, Rebrov A P
Ter Arkh. 2007;79(3):11-4.
To determine the death risk factors in patients with chronic obstructive pulmonary disease (COPD) in the course of a follow-up and to study feasibility of BODE index use for prognosis in COPD patients.
A total of 86 COPD patients were followed up for 3-5 years. The examination included total blood count, ECG, estimation of body mass index, external respiration function, pulsoxymetry, measurement of dyspnea characteristics by MMRC scale, physical activity by a 6-min walk test. Within the follow-up time 19 patients died, 15 of them of the basic disease and its complications.
The death risk was higher in elderly patients over 60 years of age with dyspnea duration over 10 years and smoking history over 40 years (> 50 packs/year). In COPD death risk prediction factors are the following: forced expiration volume for 1 second under 40%, SaO2 < 90%, the result of 6-min walk test < 300 m, systolic pressure in the pulmonary artery above 40 mmHg, right ventricular (RV) wall thickness > 0.7 cm, R V cavity size > 3.0 cm, relative delatation of the right atrium (index < 0.9), R V diastolic dysfunction, symptoms of circulatory decompensation, predisposition to a hyperkinetic type of circulation. When BODE index was compared to the above data, its reliability as a factor of death prognosis in COPD was higher.
BODE index can be used as a simple integrative index of death risk in COPD.
确定慢性阻塞性肺疾病（COPD）患者随访过程中的死亡危险因素，并研究BODE指数用于COPD患者预后评估的可行性。
对86例COPD患者进行了3至5年的随访。检查项目包括血常规、心电图、体重指数评估、肺通气功能、脉搏血氧饱和度测定、采用MMRC量表评估呼吸困难特征、通过6分钟步行试验评估体力活动情况。在随访期间，19例患者死亡，其中15例死于基础疾病及其并发症。
年龄超过60岁、呼吸困难持续时间超过10年且吸烟史超过40年（>50包/年）的老年患者死亡风险更高。COPD死亡风险的预测因素如下：1秒用力呼气容积低于40%、动脉血氧饱和度（SaO2）<90%、6分钟步行试验结果<300米、肺动脉收缩压高于40 mmHg、右心室（RV）壁厚度>0.7厘米、RV腔大小>3.0厘米、右心房相对扩张（指数<0.9）、RV舒张功能障碍、循环代偿失调症状、倾向于高动力型循环。将BODE指数与上述数据进行比较时，其作为COPD死亡预后因素的可靠性更高。
BODE指数可作为COPD死亡风险的简单综合指标。
