健康状况的预测指标在三年内不会改变，而在慢性阻塞性肺疾病中，恶化会产生差异。
Predictors of health status do not change over three-year periods and exacerbation makes difference in chronic obstructive pulmonary disease.
机构信息
Faculdade de Medicina, Departamento de Clínica Médica, UNESP-Univ Estadual Paulista, Campus de Botucatu, Botucatu, SP, Brasil.
出版信息
Health Qual Life Outcomes. 2011 Dec 9;9:112. doi: 10.1186/1477-7525-9-112.
BACKGROUND
The association between disease markers and health status (HS) overtime is unclear. The aim of this study was to verify the predictors of HS at baseline and after three years in Chronic Obstructive Pulmonary Disease (COPD) patients.
METHODS
Ninety-five consecutive COPD patients (66% male, age = 67 ± 9 y, FEV1 = 58 ± 23%) underwent the following evaluations at baseline and after three years: body composition, pulse oximetry (SpO2), six-minute walk distance (6MWD), Modified edical Research Council dyspnea scale (MMRC) and Saint George's Respiratory Questionnaire (SGRQ). The Charlson comorbidity index and BODE index were calculated. COPD exacerbations during the follow-up were evaluated. At baseline, age, gender, smoking, SpO2, BODE index or its components (BMI, MMRC, FEV1 and 6MWD), and Charlson index were included in a multiple linear regression analysis with the baseline SGRQ total score as the dependent variable. After three years, we included the final values of the variables plus the number of exacerbations and the final SGRQ total score as the dependent variable.
RESULTS
SGRQ total score (42 ± 19% vs 44 ± 19%; p = 0.041) and activity domain (52 ± 21% vs 60 ± 22%; p < 0.001) deteriorated during follow-up. At baseline, BODE index was selected as a predictor of SGRQ total score (R(2) = 0.46; p < 0.001); after three years, BODE index and age were the predictors (R(2) = 0.49; p < 0.001). When the BODE index was replaced by its variables, MMRC was selected as the only variable associated with the SGRQ total score (R(2) = 0.58; p < 0.001). After three years, MMRC, FEV1 and number of exacerbations were selected as predictors of SGRQ total score (R(2) = 0.63; p < 0.001).
CONCLUSION
HS deteriorated significantly over the three-year period and the predictors of HS do not change over time. BODE index and dyspnea were predictors at baseline and after three years. Exacerbation was also a predictor of HS after three years.
TRIAL REGISTRATION
ClinicalTrials.gov: NCT00605540.
背景
疾病标志物与健康状况（HS）随时间的关联尚不清楚。本研究的目的是验证慢性阻塞性肺疾病（COPD）患者基线和 3 年后 HS 的预测因素。
方法
95 例连续 COPD 患者（66%为男性，年龄=67±9 岁，FEV1=58±23%）在基线和 3 年后接受以下评估：人体成分、脉搏血氧饱和度（SpO2）、6 分钟步行距离（6MWD）、改良医学研究委员会呼吸困难量表（MMRC）和圣乔治呼吸问卷（SGRQ）。计算 Charlson 合并症指数和 BODE 指数。评估随访期间的 COPD 加重情况。在基线时，将年龄、性别、吸烟、SpO2、BODE 指数或其组成部分（BMI、MMRC、FEV1 和 6MWD）以及 Charlson 指数纳入与基线 SGRQ 总分作为因变量的多元线性回归分析。3 年后，我们将变量的最终值加上加重次数和最终 SGRQ 总分作为因变量。
结果
SGRQ 总分（42±19%比 44±19%；p=0.041）和活动领域（52±21%比 60±22%；p<0.001）在随访期间恶化。在基线时，BODE 指数被选为 SGRQ 总分的预测因素（R2=0.46；p<0.001）；3 年后，BODE 指数和年龄是预测因素（R2=0.49；p<0.001）。当 BODE 指数被其变量替代时，MMRC 被选为与 SGRQ 总分相关的唯一变量（R2=0.58；p<0.001）。3 年后，MMRC、FEV1 和加重次数被选为 SGRQ 总分的预测因素（R2=0.63；p<0.001）。
结论
HS 在 3 年内显著恶化，HS 的预测因素随时间不变。BODE 指数和呼吸困难是基线和 3 年后的预测因素。加重也是 3 年后 HS 的预测因素。
试验注册
ClinicalTrials.gov：NCT00605540。
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