Okubadejo A A, Jones P W, Wedzicha J A
Respiratory Care Unit, London Chest Hospital.
Thorax. 1996 Jan;51(1):44-7. doi: 10.1136/thx.51.1.44.
Patients with severe chronic obstructive pulmonary disease (COPD) have impairment in most areas of quality of life, but a relationship between impairment of the partial pressure of oxygen in arterial blood (PaO2) and quality of life has not been established. Previous studies used general health measures such as the Sickness Impact Profile (SIP). In this study a disease-specific health measure, the St George's Respiratory Questionnaire (SGRQ), was used to examine the relationship.
Forty one patients (20 men) of median age 71 years (range 47-85) with COPD were assessed. Forced expiratory volume in one second (FEV1), PaO2 and partial pressure of carbon dioxide in the arterial blood (PaCO2) were measured, and the patients completed the SGRQ, SIP, and the Hospital Anxiety and Depression Scale (HAD).
The mean (SD) values were: FEV1, 0.83 (0.29) litres; PaO2, 7.49 (1.03) kPa; PaCO2, 6.30 (1.05) kPa; SGRQ total score, 55.3 (18.2); SIP total score 15.4 (9.2); anxiety score, 5.7 (4.3); depression score, 5.3 (3.4). PaO2 was significantly correlated with the SGRQ total scores but not with the SIP total score. The SGRQ total score also correlated with anxiety and depression. Multivariate analysis showed that depression score and PaO2 were both significant covariates of the SGRQ total score.
These findings suggest that, in patients with severe COPD, quality of life is related to the severity of hypoxaemia, but this relationship is only detectable when using a disease-specific health measure.
重度慢性阻塞性肺疾病(COPD)患者在生活质量的大多数方面都存在损害,但动脉血氧分压(PaO₂)损害与生活质量之间的关系尚未确立。以往研究使用一般健康测量方法,如疾病影响量表(SIP)。在本研究中,使用特定疾病的健康测量方法——圣乔治呼吸问卷(SGRQ)来研究这种关系。
对41例COPD患者(20例男性)进行评估,中位年龄71岁(范围47 - 85岁)。测量一秒用力呼气容积(FEV₁)、PaO₂和动脉血二氧化碳分压(PaCO₂),患者完成SGRQ、SIP及医院焦虑抑郁量表(HAD)。
平均值(标准差)分别为:FEV₁,0.83(0.29)升;PaO₂,7.49(1.03)kPa;PaCO₂,6.30(1.05)kPa;SGRQ总分,55.3(18.2);SIP总分15.4(9.2);焦虑评分,5.7(4.3);抑郁评分,5.3(3.4)。PaO₂与SGRQ总分显著相关,但与SIP总分无关。SGRQ总分也与焦虑和抑郁相关。多变量分析显示,抑郁评分和PaO₂均为SGRQ总分的显著协变量。
这些发现表明,在重度COPD患者中,生活质量与低氧血症的严重程度相关,但这种关系仅在使用特定疾病的健康测量方法时才可检测到。