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如何对稳定期慢性阻塞性肺疾病男性患者进行气流受限分级?

How to Stage Airflow Limitation in Stable Chronic Obstructive Pulmonary Disease Male Patients?

机构信息

Laboratory of Physiology and Functional Explorations, Farhat HACHED Hospital, Sousse, Tunisia.

Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED Hospital, Sousse, Tunisia.

出版信息

Am J Mens Health. 2020 May-Jun;14(3):1557988320922630. doi: 10.1177/1557988320922630.

Abstract

No study has evaluated the utility of different classifications of chronic obstructive pulmonary disease (COPD) airflow limitation (AFL) in terms of the refined "ABCD" classification of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) or in terms of the impacts on quality of life. This study aimed to compare some relevant health outcomes (i.e., GOLD classification and quality-of-life scores) between COPD patients having "light" and "severe" AFL according to five COPD AFL classifications. It was a cross-sectional prospective study including 55 stable COPD male patients. The COPD assessment test (CAT), the VQ11 quality-of-life questionnaire, a spirometry, and a bronchodilator test were performed. The patients were divided into GOLD "A/B" and "C/D." The following five classifications of AFL severity, based on different post-bronchodilator forced expiratory volume in 1 s (FEV) expressions, were applied: FEV: "light" (≥50), "severe" (<50); FEV: "light" (≥-3), "severe" (<-3); FEV/height: "light" (≥0.40), "severe" (<0.40); FEV/height: "light" (≥0.29), "severe" (<0.29); and FEV: "light" (≥2.50), "severe" (<2.50). The percentages of the patients with "severe" AFL were significantly influenced by the applied classification of the AFL severity (89.1 [FEV], 63.6 [FEV], 41.8 [FEV/height], 40.0 [FEV], and 25.4 [FEV/height]; Cochrane test = 91.49, df = 4). The CAT and VQ11 scores were significantly different between the patients having "light" and "severe" AFL. In GOLD "C/D" patients, only the FEV was able to distinguish between the two AFL severities. To conclude, the five classifications of COPD AFL were not similar when compared with regard to some relevant health outcomes.

摘要

尚无研究评估慢性阻塞性肺疾病(COPD)气流受限(AFL)的不同分类在全球慢性阻塞性肺疾病倡议(GOLD)的“ABCD”精细分类或对生活质量的影响方面的效用。本研究旨在比较根据五种 COPD AFL 分类,根据 COPD AFL 严重程度分类(即 GOLD 分类和生活质量评分),COPD 患者中“轻度”和“重度”AFL 的一些相关健康结果。这是一项包括 55 例稳定 COPD 男性患者的横断面前瞻性研究。进行了 COPD 评估测试(CAT)、VQ11 生活质量问卷、肺量测定和支气管扩张剂测试。患者被分为 GOLD“A/B”和“C/D”。应用以下五种不同的 AFL 严重程度分类,基于不同的支气管扩张剂后 1 秒用力呼气量(FEV)表达:FEV:“轻度”(≥50),“重度”(<50);FEV:“轻度”(≥-3),“重度”(< -3);FEV/身高:“轻度”(≥0.40),“重度”(<0.40);FEV/身高:“轻度”(≥0.29),“重度”(<0.29);和 FEV:“轻度”(≥2.50),“重度”(<2.50)。应用的 AFL 严重程度分类显著影响“重度”AFL 患者的比例(89.1[FEV]、63.6[FEV]、41.8[FEV/身高]、40.0[FEV]和 25.4[FEV/身高];Cochrane 检验=91.49,df=4)。CAT 和 VQ11 评分在“轻度”和“重度”AFL 患者之间存在显著差异。在 GOLD“C/D”患者中,只有 FEV 能够区分两种 AFL 严重程度。总之,当涉及一些相关健康结果时,COPD AFL 的五种分类并不相似。

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