系统性硬化症患者的呼吸困难评估和肺动脉高压：加利福尼亚大学圣地亚哥分校呼吸困难问卷的应用。

Dyspnea assessment and pulmonary hypertension in patients with systemic sclerosis: utility of the University of California, San Diego, Shortness of Breath Questionnaire.

机构信息

Stanford University and VA Palo Alto Health Care System, Palo Alto, California 94305, USA.

出版信息

Arthritis Care Res (Hoboken). 2013 Mar;65(3):454-63. doi: 10.1002/acr.21827.

DOI:10.1002/acr.21827

PMID:23042670

Abstract

OBJECTIVE

The University of California in San Diego Shortness of Breath Questionnaire (UCSD SOBQ) has been used to assess dyspnea-related activity limitation in patients with airway and parenchymal lung disease. We sought to assess the construct validity and responsiveness of the UCSD SOBQ in systemic sclerosis (SSc; scleroderma) patients with incident pulmonary hypertension (PH) and those at high risk of developing PH.

METHODS

We used data from 179 patients enrolled in the Pulmonary Hypertension Assessment and Recognition of Outcomes in Scleroderma Registry with pre-PH (defined by criteria on pulmonary function tests and/or echocardiogram) or definite PH with mean pulmonary artery pressure ≥25 mm Hg by right-sided heart catheterization within 6 months of enrollment. For this analysis, we included those subjects with complete data for self-reported measures at baseline and at 12 months.

RESULTS

At baseline, the UCSD SOBQ had strong correlations in the expected direction with the disability index (DI) of the Health Assessment Questionnaire (HAQ) (r = 0.71, P < 0.0001), dyspnea assessment by visual analog scale (r = 0.71, P < 0.0001), and the Short Form 36 (SF-36) health survey physical component summary (PCS) score (r = -0.77, P < 0.0001), as well as a moderate correlation with the 6-minute walk test distance (r = -0.33, P < 0.0001), Borg dyspnea score (r = 0.47, P < 0.0001), and diffusing capacity of carbon monoxide (r = -0.33, P < 0.0001). Change in the UCSD SOBQ at 12 months correlated in the expected direction with change in the HAQ DI (r = 0.54, P < 0.0001) and change in the SF-36 PCS (r = -0.44, P < 0.0001). Multivariate analysis adjusting for age, sex, and race identified male sex as a significant predictor of death (odds ratio [OR] 7.00, 95% confidence interval [95% CI] 1.55-31.76), while the UCSD SOBQ showed a strong trend toward significance (OR 1.82, 95% CI 0.97-3.41).

CONCLUSIONS

The UCSD SOBQ demonstrates good construct validity and responsiveness to change in SSc patients with pulmonary vascular disease.

摘要

目的

加利福尼亚大学圣地亚哥短气问卷（UCSD SOBQ）已被用于评估气道和实质肺疾病患者与呼吸困难相关的活动受限。我们旨在评估 UCSD SOBQ 在系统性硬化症（SSc；硬皮病）患者中的结构有效性和反应性，这些患者患有新发肺动脉高压（PH）或有发生 PH 的高风险。

方法

我们使用了 179 名患者的数据，这些患者参加了肺动脉高压评估和识别硬皮病登记处，在登记后 6 个月内通过右心导管检查发现有肺动脉高压（定义为肺功能检查和/或超声心动图标准）或明确的 PH，平均肺动脉压≥25mmHg。对于此分析，我们纳入了基线和 12 个月时具有完整自我报告测量数据的受试者。

结果

在基线时，UCSD SOBQ 与健康评估问卷（HAQ）残疾指数（DI）（r = 0.71，P <0.0001）、视觉模拟量表呼吸困难评估（r = 0.71，P <0.0001）、36 项简短健康调查（SF-36）健康调查身体成分综合评分（PCS）（r = -0.77，P <0.0001）呈强烈的预期方向相关，与 6 分钟步行试验距离（r = -0.33，P <0.0001）、Borg 呼吸困难评分（r = 0.47，P <0.0001）和一氧化碳弥散量（r = -0.33，P <0.0001）呈中度相关。12 个月时 UCSD SOBQ 的变化与 HAQ DI 的变化呈预期方向相关（r = 0.54，P <0.0001），与 SF-36 PCS 的变化呈负相关（r = -0.44，P <0.0001）。多元分析调整年龄、性别和种族后，发现男性是死亡的显著预测因素（比值比[OR]7.00，95%置信区间[95%CI]1.55-31.76），而 UCSD SOBQ 则显示出显著的趋势（OR 1.82，95%CI 0.97-3.41）。