Guyatt G H, Townsend M, Keller J, Singer J, Nogradi S
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Respir Med. 1991 Sep;85 Suppl B:17-21; discussion 33-7.
The optimal method of assessing the effect of treatment on the day-to-day function of patients with chronic airflow limitation has not yet been established. Therefore, we examined the performance of the 6-min walk test, a rating of dyspnea following the walk test, and three different questionnaires measuring dyspnea in daily activities, in a controlled trial of inhaled salbutamol and oral theophylline in 24 patients with primary fixed chronic airflow limitation. Clinically important and statistically significant effects of salbutamol and theophylline on dyspnea during the day-to-day activities were detected by each measure, but the Chronic Respiratory Questionnaire (CRQ) was more powerful than the other questionnaires, either the Oxygen Cost Diagram or the Medical Research Council Dyspnea Questionnaire as modified by the Rand Corporation. Changes in the CRQ dyspnea score showed a higher correlation with changes in spirometry, walk test score, dyspnea following the walk test, and global ratings of dyspnea than did the other two measures. We conclude that the CRQ is a responsive, valid measure of functional status for clinical trials in chronic lung disease.
评估治疗对慢性气流受限患者日常功能影响的最佳方法尚未确立。因此，在一项针对24例原发性固定性慢性气流受限患者的吸入沙丁胺醇和口服茶碱对照试验中，我们检测了6分钟步行试验的表现、步行试验后的呼吸困难评分以及三种测量日常活动中呼吸困难的不同问卷。每种测量方法均检测到沙丁胺醇和茶碱对日常活动期间呼吸困难具有临床重要且具有统计学意义的效果，但慢性呼吸问卷（CRQ）比其他问卷更有效，无论是氧气消耗图还是由兰德公司修改的医学研究委员会呼吸困难问卷。与其他两种测量方法相比，CRQ呼吸困难评分的变化与肺功能测定、步行试验评分、步行试验后的呼吸困难以及呼吸困难总体评分的变化具有更高的相关性。我们得出结论，CRQ是慢性肺病临床试验中功能状态的一种敏感、有效的测量方法。
