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特发性肺纤维化急性加重后的日常生活活动能力

The Activities of Daily Living after an Acute Exacerbation of Idiopathic Pulmonary Fibrosis.

作者信息

Koyama Kazuya, Sakamoto Susumu, Isshiki Takuma, Shimizu Hiroshige, Kurosaki Atsuko, Homma Sakae

机构信息

Division of Respiratory Medicine, Toho University Omori Medical Center, Japan.

Department of Diagnostic Radiology, Fukujuji Hospital, Japan.

出版信息

Intern Med. 2017 Nov 1;56(21):2837-2843. doi: 10.2169/internalmedicine.7875-16. Epub 2017 Sep 25.

Abstract

Objective An acute exacerbation (AE) of idiopathic pulmonary disease (IPF) represents a life threatening condition. The activities of daily living (ADL) and quality of life of patients who survive an AE of IPF (AE-IPF) are often diminished. However, the association between AE-IPF and the ADL has yet to be evaluated. To evaluate the effect of AE-IPF on the ADL. Methods, Patients Patients treated for AE-IPF from 2010 to 2014 were identified. We retrospectively evaluated their ADL before and after AE-IPF using a modified Barthel index (BI) composed of 6 items. Results Twenty-eight of the 47 AE-IPF patients remained alive at 3 months after the onset of AE-IPF. The BI values of 22 survivors (79%) showed a full score (70 points) before the onset of AE-IPF. The evaluation of the BI scores at four weeks after the onset of AE-IPF revealed that the scores of 12 patients had decreased by >15 points and more than half of the survivors showed scores of <55. Logistic regression analyses showed that persistent hypeoxemia at 28 days after an AE, both at exertion (odds ratio, 24.20; 95% confidence interval, 2.42-242.31; p=0.009) and at rest (odds ratio, 21.00; 95% confidence interval, 2.05-215.18; p=0.010), was associated with a >15-point decrease in the BI score at 4 weeks after AE-IPF. Conclusion AE-IPF survivors with persistent hypoxemia showed diminished ADL after treatment.

摘要

目的 特发性肺疾病(IPF)急性加重(AE)是一种危及生命的状况。IPF急性加重(AE-IPF)幸存者的日常生活活动能力(ADL)和生活质量常常下降。然而,AE-IPF与ADL之间的关联尚未得到评估。旨在评估AE-IPF对ADL的影响。方法 患者 确定2010年至2014年接受AE-IPF治疗的患者。我们使用由6个项目组成的改良Barthel指数(BI)对他们在AE-IPF前后的ADL进行回顾性评估。结果 47例AE-IPF患者中有28例在AE-IPF发病后3个月仍存活。22例幸存者(79%)在AE-IPF发病前BI值显示为满分(70分)。对AE-IPF发病后四周的BI评分评估显示,12例患者的评分下降超过15分,且超过一半的幸存者评分<55分。逻辑回归分析表明,AE后28天无论是运动时(比值比,24.20;95%置信区间,2.42-242.31;p=0.009)还是静息时(比值比,21.00;95%置信区间,2.05-215.18;p=0.010)持续存在低氧血症,均与AE-IPF发病后4周BI评分下降>15分相关。结论 持续低氧血症的AE-IPF幸存者治疗后ADL下降。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a05/5709624/2a4447aac267/1349-7235-56-2837-g001.jpg

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