AP-HP, Hôpital Européen Georges Pompidou, Service de Pneumologie, Paris, France.
Respir Physiol Neurobiol. 2012 Jun 15;182(1):18-25. doi: 10.1016/j.resp.2012.02.004. Epub 2012 Feb 17.
Sensory (physiological) and affective (psychological) dimensions of dyspnea have been described but the usefulness of measuring psychological status in addition to ventilatory capacity (spirometry, lung volumes) in the assessment of exertional dyspnea remains controversial. We hypothesized that activity-related dyspnea would not be modified by psychological status. Principal component analysis (PCA) was used to reduce the number of parameters (psychological or functional) to fewer independent dimensions in 328 patients with altered ventilatory capacity: severe obesity (BMI ≥ 35, n = 122), COPD (n = 128) or interstitial lung disease (n = 78). PCA demonstrated that psychological status (Hospital Anxiety-Depression, Fatigue Impact scales) and dyspnea (Medical Research Council [MRC] scale) were independent dimensions. Ventilatory capacity was described by three main dimensions by PCA related to airways, volumes, and their combination (specific airway resistance, FEV(1)/FVC), which were weakly correlated with dyspnea. In conclusion, in patients with COPD, interstitial lung disease or severe obesity, psychological status does not modify activity-related dyspnea rating as evaluated by the MRC scale.
已经描述了呼吸困难的感觉(生理)和情感(心理)维度,但在评估运动性呼吸困难时,除了通气能力(肺量计、肺容积)之外,测量心理状态的有用性仍然存在争议。我们假设与活动相关的呼吸困难不会受到心理状态的影响。主成分分析(PCA)用于将参数(心理或功能)的数量减少到 328 名通气能力改变的患者的更少独立维度:严重肥胖(BMI≥35,n=122)、COPD(n=128)或间质性肺疾病(n=78)。PCA 表明,心理状态(医院焦虑抑郁量表、疲劳影响量表)和呼吸困难(医学研究委员会[MRC]量表)是独立的维度。通过与气道、容量及其组合(特异性气道阻力、FEV1/FVC)相关的 PCA,通气能力由三个主要维度来描述,这与呼吸困难弱相关。总之,在 COPD、间质性肺疾病或严重肥胖患者中,MRC 量表评估的与活动相关的呼吸困难评分不受心理状态的影响。