Karapolat Hale, Eyigor Sibel, Atasever Alev, Zoghi Mehdi, Nalbantgil Sanem, Durmaz Berrin
Ege University Medical Faculty Physical Medicine and Rehabilitation Department, Turkey.
Chin Med J (Engl). 2008 Apr 5;121(7):592-6.
Chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF) are two chronic diseases that affect negatively the functional condition and quality of life of patients. We assessed the effect of symptoms and clinical variables on the functional capacity and quality of life in COPD and CHF patients.
The study included 42 COPD and 39 CHF patients. In both patient groups, dyspnea was assessed using Borg scale; functional capacity by shuttle-walk and cardiopulmonary exercise test and quality of life by short form-36 (SF36).
No statistically significant difference was found in neither of the two disease groups regarding the dyspnea score, shuttle-walk test and the majority of subgroup scores of SF36 (P > 0.05). A statistically significant difference was observed in peak VO2 in favor of COPD group (P < 0.05). No significant relationship was established between dyspnea score and forced expiratory volume in one second (FEV1) in COPD patients, and left ventricular ejection fraction (LVEF) in CHF patients (P > 0.05). A significant negative correlation was observed between dyspnea score and functional capacity tests in both disease groups (P < 0.05). On the other hand, no relationship was found between LVEF and FEV1 and quality of life and functional capacity (P > 0.05).
It was revealed that symptoms have an impact on functional capacity and quality of life in both disease groups, however, objective indicators of disease severity do not show a similar relationship. Therefore, in addition to the objective data related to the disease, we recommend that symptoms should also be taken into consideration to assess cardiopulmonary rehabilitation program and during following-up.
慢性阻塞性肺疾病(COPD)和充血性心力衰竭(CHF)是两种对患者功能状况和生活质量产生负面影响的慢性疾病。我们评估了症状和临床变量对COPD和CHF患者功能能力和生活质量的影响。
该研究纳入了42例COPD患者和39例CHF患者。在两组患者中,使用Borg量表评估呼吸困难;通过往返步行试验和心肺运动试验评估功能能力,通过简短健康调查问卷(SF-36)评估生活质量。
在两组疾病患者中,呼吸困难评分、往返步行试验以及SF-36的大多数亚组评分均未发现有统计学显著差异(P>0.05)。在峰值摄氧量方面观察到有利于COPD组的统计学显著差异(P<0.05)。COPD患者的呼吸困难评分与一秒用力呼气容积(FEV1)之间,以及CHF患者的左心室射血分数(LVEF)之间均未建立显著关系(P>0.05)。在两组疾病中,呼吸困难评分与功能能力测试之间均观察到显著的负相关(P<0.05)。另一方面,未发现LVEF与FEV1以及生活质量与功能能力之间存在关系(P>0.05)。
结果显示,症状对两组疾病患者的功能能力和生活质量均有影响,然而,疾病严重程度的客观指标并未显示出类似关系。因此,除了与疾病相关的客观数据外,我们建议在评估心肺康复计划和随访期间也应考虑症状因素。