圣乔治呼吸问卷评估慢性肺曲霉病患者健康状况的有效性和可靠性。

Validity and reliability of the St. George's Respiratory Questionnaire in assessing health status in patients with chronic pulmonary aspergillosis.

机构信息

UK National Aspergillosis Centre, University Hospital of South Manchester, The University of Manchester, Manchester Academic Health Science Centre, Manchester, England; College of Medicine, Hadhramout University of Science and Technology, Hadhramout, Yemen.

UK National Aspergillosis Centre, University Hospital of South Manchester, The University of Manchester, Manchester Academic Health Science Centre, Manchester, England.

出版信息

Chest. 2013 Aug;144(2):623-631. doi: 10.1378/chest.12-0014.

DOI:10.1378/chest.12-0014

PMID:23188518

Abstract

BACKGROUND

Chronic pulmonary aspergillosis (CPA) markedly reduces lung function through progressive lung destruction. To date, however, health status in patients with CPA has not been studied. This is due, in part, to a lack of adequately validated scales. The St. George's Respiratory Questionnaire (SGRQ) is widely used for several chronic respiratory diseases, but not for CPA. We examined the reliability and validity of SGRQ in CPA.

METHODS

Eighty-eight patients with CPA completed the SGRQ, the Short Form-36 Health Survey (SF-36), and the Medical Research Council (MRC) dyspnea scale. Lung function and BMI were also measured. Pearson correlation, t test, analysis of variance, and their equivalents for nonparametric data and multivariate linear and binary analyses were used.

RESULTS

The SGRQ components (symptoms, activity, and impact) and total scores achieved high internal consistency (Cronbach α = 0.77, 0.91, 0.86, and 0.94), and SGRQ components had good intercorrelation (r ≥ 0.41; P < .001) and correlated well with the total score (r ≥ 0.63; P < .001). There were high, intraclass, correlation coefficients for the total SGRQ and its dimensions (≥ 0.92). The SGRQ scores showed significant correlation with the MRC dyspnea scale and SF-36 components and differentiated between all grades of shortness of breath and different bands of disease severity (P < .05). In addition, patients with greater clinician-rated disease severity had more impairment of health status (P < .006). CPA severity was independently associated with impairment in health status, and COPD comorbidity significantly affected the health status in patients with CPA.

CONCLUSIONS

SGRQ demonstrated a significant level of reliability and validity in measuring health status in CPA.

摘要

背景

慢性肺曲霉病（CPA）通过进行性肺破坏显著降低肺功能。然而，迄今为止，尚未对 CPA 患者的健康状况进行研究。部分原因是缺乏足够验证的量表。圣乔治呼吸问卷（SGRQ）广泛用于多种慢性呼吸系统疾病，但不适用于 CPA。我们检查了 SGRQ 在 CPA 中的可靠性和有效性。

方法

88 例 CPA 患者完成了 SGRQ、36 项简短健康调查（SF-36）和医学研究委员会（MRC）呼吸困难量表。还测量了肺功能和 BMI。使用 Pearson 相关、t 检验、方差分析及其非参数数据和多元线性和二项分析的等效方法。

结果

SGRQ 各组成部分（症状、活动和影响）和总分具有较高的内部一致性（Cronbach α=0.77、0.91、0.86 和 0.94），并且 SGRQ 各组成部分之间具有良好的相关性（r≥0.41；P <.001），与总分相关性良好（r≥0.63；P <.001）。SGRQ 总分及其各维度的组内相关系数均较高（≥0.92）。SGRQ 评分与 MRC 呼吸困难量表和 SF-36 各组成部分之间存在显著相关性，并区分了所有呼吸困难程度等级和不同疾病严重程度等级（P <.05）。此外，临床医生评估的疾病严重程度越高，健康状况受损越严重（P <.006）。CPA 严重程度与健康状况受损独立相关，COPD 合并症显著影响 CPA 患者的健康状况。