根据所使用的问卷，慢性阻塞性肺疾病全球倡议（GOLD）象限的身体活动特征有所不同。
Physical Activity Characteristics across GOLD Quadrants Depend on the Questionnaire Used.
作者信息
Demeyer Heleen, Gimeno-Santos Elena, Rabinovich Roberto A, Hornikx Miek, Louvaris Zafeiris, de Boer Willem I, Karlsson Niklas, de Jong Corina, Van der Molen Thys, Vogiatzis Ioannis, Janssens Wim, Garcia-Aymerich Judith, Troosters Thierry, Polkey Michael I
机构信息
KU Leuven, Department of Rehabilitation Sciences, B-3000, Leuven, Belgium.
University Hospitals Leuven, Department of Respiratory Diseases, B-3000, Leuven, Belgium.
出版信息
PLoS One. 2016 Mar 14;11(3):e0151255. doi: 10.1371/journal.pone.0151255. eCollection 2016.
BACKGROUND
The GOLD multidimensional classification of COPD severity combines the exacerbation risk with the symptom experience, for which 3 different questionnaires are permitted. This study investigated differences in physical activity (PA) in the different GOLD quadrants and patient's distribution in relation to the questionnaire used.
METHODS
136 COPD patients (58±21% FEV1 predicted, 34F/102M) completed COPD assessment test (CAT), clinical COPD questionnaire (CCQ) and modified Medical Research Council (mMRC) questionnaire. Exacerbation history, spirometry and 6MWD were collected. PA was objectively measured for 2 periods of 1 week, 6 months apart, in 5 European centres; to minimise seasonal and clinical variation the average of these two periods was used for analysis.
RESULTS
GOLD quadrants C+D had reduced PA compared with A+B (3824 [2976] vs. 5508 [4671] steps.d-1, p<0.0001). The choice of questionnaire yielded different patient distributions (agreement mMRC-CAT κ = 0.57; CCQ-mMRC κ = 0.71; CCQ-CAT κ = 0.72) with different clinical characteristics. PA was notably lower in patients with an mMRC score ≥2 (3430 [2537] vs. 5443 [3776] steps.d-1, p <0.001) in both the low and high risk quadrants.
CONCLUSIONS
Using different questionnaires changes the patient distribution and results in different clinical characteristics. Therefore, standardization of the questionnaire used for classification is critical to allow comparison of different studies using this as an entry criterion.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov NCT01388218.
背景
慢性阻塞性肺疾病（COPD）严重程度的GOLD多维分类将急性加重风险与症状体验相结合，允许使用3种不同的问卷。本研究调查了不同GOLD象限中体力活动（PA）的差异以及与所使用问卷相关的患者分布情况。
方法
136例COPD患者（预计FEV1为58±21%，34例女性/102例男性）完成了COPD评估测试（CAT）、临床COPD问卷（CCQ）和改良医学研究委员会（mMRC）问卷。收集急性加重病史、肺功能测定和6分钟步行距离（6MWD）。在5个欧洲中心对PA进行了为期2周、间隔6个月的客观测量；为尽量减少季节和临床变化，将这两个时期的平均值用于分析。
结果
与A+B象限相比，GOLD象限C+D的PA降低（分别为3824[2976]步/天和5508[4671]步/天，p<0.0001）。问卷的选择产生了不同的患者分布（mMRC与CAT的一致性κ=0.57；CCQ与mMRC的一致性κ=0.71；CCQ与CAT的一致性κ=0.72），且具有不同的临床特征。在低风险和高风险象限中，mMRC评分≥2的患者PA显著较低（分别为3430[步/天2537]和5443[步/天3776]，p<0.001）。
结论
使用不同的问卷会改变患者分布并导致不同的临床特征。因此，用于分类的问卷标准化对于允许使用此作为纳入标准的不同研究进行比较至关重要。
临床试验注册
ClinicalTrials.gov NCT01388218。
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