Mador M J, Rodis A, Magalang U J
Division of Pulmonary and Critical Care Medicine, State University of New York at Buffalo, USA.
Chest. 1995 Jun;107(6):1590-7. doi: 10.1378/chest.107.6.1590.
The purpose of this study was to evaluate the moderate term (5 weeks) reproducibility of Borg scale ratings of the effort to breathe (Borge) and the degree of discomfort evoked by breathing (Borgd) in patients with COPD during exercise. Six subjects with moderately severe COPD (FEV1, 1.42 +/- 0.50 L) underwent progressive incremental exercise (15 W/min) on a cycle ergometer to a symptom-limited maximum every week for 6 weeks (first week used as practice session). Minute ventilation (VE), oxygen consumption (VO2), and Borg ratings were obtained every minute during exercise. Borge and Borgd were highly correlated in each subject (r = 0.99 +/- 0.01). Borg scores were not significantly different across study days during both maximal and submaximal exercise. The within-subject coefficient of variation (CV) for Borge during maximal exercise was 13.9 +/- 9.0% (range, 6 to 31%) which was not significantly different from that observed for the physiological indices: 8.2 +/- 4.1% (range, 4 to 15%) for VE and 5.2 +/- 3.4% (range, 1 to 10%) for VO2. In contrast, at 66% of the maximum workload, the within-subject CV for Borge was 25.0 +/- 13.6% (range, 12 to 50%) which was significantly greater than that observed for the physiologic indices: 5.8 +/- 2.0% (range, 3 to 9%) for VE and 4.6 +/- 1.1% (range, 3 to 6%) for VO2. In every subject, Borge was linearly correlated with VE, VO2, and workload. However, within an individual subject, the slope of these relationships varied between trials; within-subject CV for the slope of the Borge/VE relationship was 20.2 +/- 8.0% (range, 12 to 32%). In conclusion, during incremental exercise Borg ratings of dyspnea are not as reproducible as physiologic indices in patients with COPD.
本研究旨在评估慢性阻塞性肺疾病（COPD）患者运动期间呼吸用力的Borg量表评分（Borge）及呼吸引起的不适程度（Borgd）在中期（5周）的可重复性。6例中度重度COPD患者（第1秒用力呼气容积[FEV1]为1.42±0.50L）每周在功率自行车上进行1次症状限制最大量的递增运动（15W/分钟），共进行6周（第1周为练习阶段）。运动期间每分钟记录分钟通气量（VE）、耗氧量（VO2）及Borg评分。每位受试者的Borge与Borgd高度相关（r=0.99±0.01）。在最大运动及次最大运动期间，各研究日的Borg评分无显著差异。最大运动时Borge的受试者内变异系数（CV）为13.9±9.0%（范围6%至31%），与生理指标的变异系数无显著差异：VE为8.2±4.1%（范围4%至15%），VO2为5.2±3.4%（范围1%至10%）。相比之下，在最大工作量的66%时，Borge的受试者内CV为25.0±13.6%（范围12%至50%），显著高于生理指标的变异系数：VE为5.8±2.0%（范围3%至9%），VO2为4.6±1.1%（范围3%至6%）。在每位受试者中，Borge与VE、VO2及工作量呈线性相关。然而，在个体受试者内，这些关系的斜率在各次试验间有所不同；Borge/VE关系斜率的受试者内CV为20.2±8.0%（范围12%至32%）。总之，在递增运动期间，COPD患者的呼吸困难Borg评分不如生理指标可重复。
