一种用于慢性阻塞性肺疾病患者运动时呼吸困难评级的新方法。

A new method for rating dyspnea during exercise in patients with chronic obstructive pulmonary disease.

机构信息

Department of Respiratory Medicine, Capital Medical University, Beijng 100050, China.

出版信息

Chin Med J (Engl). 2013;126(19):3616-20.

Abstract

BACKGROUND

The Borg scale is most commonly used to measure dyspnea in China. However, many patients that find it is difficult to distinguish the labeled numbers corresponding to different dyspnea scores. We developed a new method to rate dyspnea, which we call the count scale (CS). It includes the count scale number (CSN) and count scale time (CST). The aims of the present study were to determine the reproducibility and sensitivity of the CS during exercise in patients with chronic obstructive pulmonary disease (COPD).

METHODS

Fourteen male patients with COPD (aged 58.00 ± 7.72 years) participated in this study. A progressive incremental exercise and a 6-minute constant work exercise test were performed every 2 to 3 days for a total of 3 times. The CS results were evaluated at rest and at 30% and 70% of maximal workload (Wmax) and Wmax. The Borg scales were obtained during exercise.

RESULTS

No significant differences occurred across the three trials during exercise for the CS and Borg scores. The CSN and CST were more varied at Wmax (coefficient of variation (CV) = (22.28 ± 16.96)% for CSN, CV = (23.08 ± 19.11)% for CST) compared to 30% of Wmax (CV = (11.92 ± 8.78)% for CSN, CV = (11.16 ± 9.96)% for CST) and 70% of Wmax (CV = (9.08 ± 7.09)% for CSN, CV = (12.19 ± 12.32)% for CST). Dyspnea ratings with either CSN or CST tended to decrease at the higher workload compared to the lower workload. CSN and CST scores were highly correlated (r = 0.861, P < 0.001). CSN was negatively correlated with Borg scores (r = -0.363, P = 0.001). Similar results were obtained for the relationship between CST and Borg scores (r = -0.345, P = 0.003).

CONCLUSION

We concluded that the CS is simple and reproducible when measuring dyspnea during exercise in patients with COPD.

摘要

背景

Borg 量表在中国常用于测量呼吸困难，但许多患者发现难以区分不同呼吸困难评分对应的标记数字。我们开发了一种新的呼吸困难评分方法，称为计数量表（CS）。它包括计数量表数字（CSN）和计数量表时间（CST）。本研究旨在确定 CS 在慢性阻塞性肺疾病（COPD）患者运动过程中的可重复性和敏感性。

方法

14 名男性 COPD 患者（年龄 58.00 ± 7.72 岁）参与了本研究。每 2-3 天进行一次递增性增量运动和 6 分钟恒功运动测试，共进行 3 次。在休息时以及最大工作量（Wmax）的 30%和 70%时评估 CS 结果。在运动过程中获得 Borg 量表评分。

结果

在运动过程中，三次试验中 CS 和 Borg 评分均无显著差异。CSN 和 CST 在 Wmax 时变化更大（CSN 的变异系数（CV）=（22.28 ± 16.96）%，CST 的 CV =（23.08 ± 19.11）%），而 30%的 Wmax（CSN 的 CV =（11.92 ± 8.78）%，CST 的 CV =（11.16 ± 9.96）%）和 70%的 Wmax（CSN 的 CV =（9.08 ± 7.09）%，CST 的 CV =（12.19 ± 12.32）%）。与较低的工作量相比，较高的工作量时 CSN 或 CST 的呼吸困难评分趋于降低。CSN 和 CST 评分高度相关（r = 0.861，P < 0.001）。CSN 与 Borg 评分呈负相关（r = -0.363，P = 0.001）。CST 与 Borg 评分的关系也有类似结果（r = -0.345，P = 0.003）。