CAT在评估慢性阻塞性肺疾病急性加重期（AECOPD）患者治疗反应中的作用。
The role of CAT in evaluating the response to treatment of patients with AECOPD.
作者信息
Zhou Aiyuan, Zhou Zijing, Peng Yating, Zhao Yiyang, Duan Jiaxi, Chen Ping
机构信息
Department of Respiratory Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China,
Research Unit of Respiratory Disease, Central South University, Changsha, Hunan 410011, China,
出版信息
Int J Chron Obstruct Pulmon Dis. 2018 Sep 11;13:2849-2858. doi: 10.2147/COPD.S175085. eCollection 2018.
BACKGROUND
The chronic obstructive pulmonary disease (COPD) Assessment Test (CAT) questionnaire is a short patient-completed questionnaire, which is used to assess the health status of patients with stable COPD. However, whether it is a good tool to evaluate the response to treatment in acute exacerbation of COPD (AECOPD) has been less studied.
METHODS
The patients were assessed at two visits, at admission and on the seventh day. Anthropometric variables were collected at admission. CAT and lung function were measured twice at the above time points. At the second visit, the health status of the patients were divided into five groups based on a 5-point Likert scale, ranging from 1 to 5, which represents "much better," "slightly better," "no change," "slightly worse," and "much worse." Responders were those who reported "much better" or "slightly better," and nonresponders were those who claimed "no change," "worse," or "much worse."
RESULTS
In total, 225 patients were recruited. The average CAT score at admission was 24.82±7.41, which declined to 17.41±7.35 on the seventh day. There were 81.33% responders, whose improvement in CAT score (9.37±5.24) was much higher than that of the nonresponders (-1.36±4.35). A moderate correlation was observed between the changes in CAT score and improvement in FEV, FEV%, and the length of hospital stay. There was a strong correlation between the changes in CAT score and health status. A 3.5-unit improvement in the CAT score, with highest area under the curve, was the cutoff to differentiate responders from nonresponders.
CONCLUSION
The evolution of CAT scores during exacerbation can provide useful information to assess the health status of patients with AECOPD. A 3.5-unit improvement in CAT score is the best cutoff to differentiate between patients who have a response or no response to treatment, which offers a convenient and easy way for clinicians to monitor the health status of patients with an AECOPD.
背景
慢性阻塞性肺疾病（COPD）评估测试（CAT）问卷是一份由患者自行填写的简短问卷，用于评估稳定期COPD患者的健康状况。然而，它是否是评估慢性阻塞性肺疾病急性加重期（AECOPD）治疗反应的良好工具，相关研究较少。
方法
在入院时和第七天对患者进行两次评估。入院时收集人体测量变量。在上述时间点对CAT和肺功能进行两次测量。在第二次评估时，根据1至5分的李克特量表将患者的健康状况分为五组，分别代表“好多了”“稍好”“无变化”“稍差”和“差得多”。有反应者是那些报告“好多了”或“稍好”的人，无反应者是那些声称“无变化”“更差”或“差得多”的人。
结果
共招募了225名患者。入院时CAT平均得分为24.82±7.41，第七天时降至17.41±7.35。有反应者占81.33%，其CAT评分改善（9.37±5.24）远高于无反应者（-1.36±4.35）。观察到CAT评分变化与第一秒用力呼气容积（FEV）、FEV占预计值百分比（FEV%）变化及住院时间之间存在中度相关性。CAT评分变化与健康状况之间存在强相关性。以曲线下面积最大的CAT评分改善3.5分为界值来区分有反应者和无反应者。
结论
急性加重期CAT评分的变化可为评估AECOPD患者的健康状况提供有用信息。CAT评分改善3.5分是区分治疗有反应和无反应患者的最佳界值，这为临床医生监测AECOPD患者的健康状况提供了一种便捷的方法。
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