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支气管扩张的存在及严重程度对慢性阻塞性肺疾病患者呼吸功能、运动能力、呼吸困难感知及生活质量的影响。

The effect of the presence and severity of bronchiectasis on the respiratory functions, exercise capacity, dyspnea perception, and quality of life in patients with chronic obstructive pulmonary disease.

作者信息

Sahin Hulya, Naz Ilknur, Susam Seher, Erbaycu Ahmet Emin, Olcay Serhan

机构信息

Pulmonary Rehabilitation Unit, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey.

Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Katip Celebi University, Izmir, Turkey.

出版信息

Ann Thorac Med. 2020 Jan-Mar;15(1):26-32. doi: 10.4103/atm.ATM_198_19. Epub 2020 Jan 2.

Abstract

BACKGROUND

Bronchiectasis is common in patients with advanced chronic obstructive pulmonary disease (COPD) and adversely affects the patients' clinical condition. This study aimed to investigate the effects of bronchiectasis on exercise capacity, dyspnea perception, disease-specific quality of life, and psychological status in patients with COPD and determine the extent of these adverse effects by the severity of bronchiectasis.

METHODS

A total of 387 COPD patients (245 patients with only COPD [Group 1] and 142 COPD patients with accompanying bronchiectasis [Group 2]) were included in the study. The patients in Group 2 were divided into three subgroups as mild, moderate, and severe using the Bronchiectasis Severity Index. Six-minute walk distance, dyspnea perception, St. George's Respiratory Questionnaire (SGRQ), and hospital anxiety and depression scores were compared between the groups.

RESULTS

In Group 2, dyspnea perception, SGRQ total scores, depression score were higher, and walking distance was lower ( = 0.001, = 0.007, = 0.001, and = 0.011, respectively). Group 2 had significantly worse arterial blood gas values. Dyspnea perception increased with the increasing severity in Group 2 ( < 0.001). Walking distance was lower in patients with severe bronchiectasis ( < 0.001). SGRQ total score, anxiety, and depression scores were significantly higher in the severe subgroup ( < 0.001, = 0.003, and = 0.002, respectively).

CONCLUSIONS

In patients with Stage 3 and 4 COPD, the presence of bronchiectasis adversely affects the clinical status of the patients, decreases their exercise capacity, deteriorates their quality of life, and disrupts their psychological status. Investigating the presence of bronchiectasis in COPD patients is crucial for early diagnosis and proper treatment.

摘要

背景

支气管扩张在晚期慢性阻塞性肺疾病(COPD)患者中很常见,并且会对患者的临床状况产生不利影响。本研究旨在调查支气管扩张对COPD患者运动能力、呼吸困难感知、疾病特异性生活质量和心理状态的影响,并根据支气管扩张的严重程度确定这些不良影响的程度。

方法

本研究共纳入387例COPD患者(245例仅患有COPD的患者[第1组]和142例伴有支气管扩张的COPD患者[第2组])。使用支气管扩张严重指数将第2组患者分为轻度、中度和重度三个亚组。比较各组之间的6分钟步行距离、呼吸困难感知、圣乔治呼吸问卷(SGRQ)以及医院焦虑和抑郁评分。

结果

在第2组中,呼吸困难感知、SGRQ总分、抑郁评分更高,而步行距离更低(分别为P = 0.001、P = 0.007、P = 用0.001和P = 0.011)。第2组的动脉血气值明显更差。在第2组中,呼吸困难感知随着严重程度的增加而增加(P < 0.001)。重度支气管扩张患者的步行距离更低(P < 0.001)。重度亚组的SGRQ总分、焦虑和抑郁评分明显更高(分别为P < 0.001、P = 0.003和P = 0.002)。

结论

在3期和4期COPD患者中,支气管扩张的存在会对患者的临床状况产生不利影响,降低其运动能力,恶化其生活质量,并扰乱其心理状态。调查COPD患者中支气管扩张的存在对于早期诊断和恰当治疗至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c1d/6967141/ebea0cf61d3a/ATM-15-26-g001.jpg

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