Pulmonary and Critical Care Section, Department of Medicine, Veteran's Administration Medical Center, SUNY/Downstate Health Sciences Center, 800 Poly Place, Brooklyn, NY 11209, USA.
Lung. 2011 Aug;189(4):269-77. doi: 10.1007/s00408-011-9308-1. Epub 2011 Jun 24.
The frequency of oxygen desaturation during daily activities in chronic obstructive pulmonary disease (COPD) is poorly defined. The BODE index predicts survival in COPD. The purpose of this study was to determine the relationship between BODE scores and oxygen saturation during daily activities.
Seventy-eight patients with COPD (FEV(1) = 37%) underwent ambulatory oximetry and activity monitoring. We defined four activity categories: Walking, Slow-Intermittent-Walking (SIW), Active-Not-Walking (ANW), and Rest. We quantified oxygen desaturation during activity using a desaturation index (DSI = % time oxygen saturation <90%). BODE scores were categorized into three groups: group I (0-3), II (4-6), and III (7-10).
The percentage of patients demonstrating oxygen desaturation (DSI ≥ 10%) during each activity was 55% for Walking, 35% for SIW, 15% for ANW, and 28% for Rest. There was a strong association between BODE score and desaturation for Walking and SIW. During Walking, 21, 44, and 86% of patients in BODE groups I, II, and III, respectively, demonstrated desaturation. The DSI for Walking and SIW was increased in patients in BODE groups II and III compared to group I (P < 0.006, P < 0.007, respectively). BODE score was also linked to long-term oxygen therapy (LTOT) usage; the majority of patients not on LTOT (89%) had a BODE score <7. The majority of patients on LTOT (84%) demonstrated desaturation during Walking, but 42% of patients not on LTOT also demonstrated desaturation. In this subgroup of patients not on LTOT, all patients with a BODE score ≥ 7 demonstrated desaturation during Walking.
The link between the BODE index and oxygen desaturation during daily activities suggests that desaturation is linked to disease severity. Our data suggest that patients with a BODE score ≥ 7 should be evaluated for desaturation during daily activities. Use of the BODE index to screen for exertional desaturation may have value as a tool that can lead to the earlier identification of patients who may be candidates for LTOT.
慢性阻塞性肺疾病（COPD）患者在日常活动中发生氧饱和度下降的频率尚未明确。BODE 指数可预测 COPD 患者的生存率。本研究旨在确定 BODE 评分与日常活动中氧饱和度之间的关系。
78 例 COPD 患者（FEV1=37%）接受了动态血氧监测和活动监测。我们定义了四个活动类别：行走、缓慢间歇性行走（SIW）、活动但不行走（ANW）和休息。我们使用脱氧指数（DSI=%时间氧饱和度<90%）来量化活动期间的氧饱和度下降。BODE 评分分为三组：I 组（0-3）、II 组（4-6）和 III 组（7-10）。
行走、SIW、ANW 和休息时，分别有 55%、35%、15%和 28%的患者出现氧饱和度下降（DSI≥10%）。BODE 评分与行走和 SIW 时的脱氧显著相关。行走时，BODE 评分 I、II 和 III 组的患者分别有 21%、44%和 86%出现脱氧。与 I 组相比，II 组和 III 组患者的行走和 SIW 的 DSI 增加（P<0.006，P<0.007）。BODE 评分也与长期氧疗（LTOT）的使用相关；大多数未接受 LTOT 的患者（89%）的 BODE 评分<7。大多数接受 LTOT 的患者（84%）在行走时出现脱氧，但 42%未接受 LTOT 的患者也出现脱氧。在未接受 LTOT 的这组患者中，所有 BODE 评分≥7 的患者在行走时均出现脱氧。
BODE 指数与日常活动中氧饱和度下降之间的联系表明，脱氧与疾病严重程度相关。我们的数据表明，BODE 评分≥7 的患者应评估日常活动中的脱氧情况。使用 BODE 指数筛查运动性脱氧可能具有作为一种工具的价值，可更早地发现可能适合 LTOT 的患者。
