Mahler D A, Harver A, Rosiello R, Daubenspeck J A
Department of Medicine, Dartmouth Medical School, Hanover, NH 03756.
Chest. 1989 Oct;96(4):767-71. doi: 10.1378/chest.96.4.767.
To evaluate measurements of respiratory sensation in ILD, we compared ratings of breathlessness from three clinical scales with the perceived magnitude of added elastic loads in 20 symptomatic ILD patients. Dyspnea ratings were obtained by two independent observers for each clinical method. Perceived magnitude of four elastic loads was selected from the Borg category scale; these estimates were summarized using the psychophysical power function equation. Ten age-matched healthy subjects also scaled the magnitude of added elastic loads. Dyspnea ratings from the three clinical scales were significantly interrelated. Mean exponents for mouth pressure developed during elastic loading were similar in the patient and control groups. Dyspnea ratings and exponents for elastic loads were not significantly correlated in ILD patients. Of the physiologic parameters examined, Dsb and gas exchange during exercise correlated significantly with clinical dyspnea ratings; none correlated with the exponent for added elastic loads. These data demonstrate that clinical dyspnea ratings provide valid measures of breathlessness in patients with ILD which are independent of the perception of respiratory loads.
为评估间质性肺疾病（ILD）患者的呼吸感觉测量值，我们比较了20例有症状ILD患者三种临床量表的呼吸困难评分与所感知的附加弹性负荷大小。由两名独立观察者针对每种临床方法获取呼吸困难评分。从博格类别量表中选取四种弹性负荷的感知大小；这些估计值使用心理物理学幂函数方程进行汇总。十名年龄匹配的健康受试者也对附加弹性负荷的大小进行了评分。三种临床量表的呼吸困难评分显著相关。弹性负荷期间产生的口腔压力的平均指数在患者组和对照组中相似。ILD患者的呼吸困难评分与弹性负荷指数无显著相关性。在所检查的生理参数中，运动期间的Dsb和气体交换与临床呼吸困难评分显著相关；均与附加弹性负荷指数无关。这些数据表明，临床呼吸困难评分可为ILD患者的呼吸急促提供有效的测量值，且与呼吸负荷的感知无关。
