Okubadejo A A, O'Shea L, Jones P W, Wedzicha J A
Respiratory Care Unit, London Chest Hospital, UK.
Eur Respir J. 1997 Jul;10(7):1572-5. doi: 10.1183/09031936.97.10071572.
In patients with severe chronic obstructive pulmonary disease (COPD) using long-term oxygen therapy (LTOT), few studies have investigated activities of daily living (ADL). We examined the relationships between ADL, quality of life, mood state and airways obstruction in patients using long-term oxygen therapy (LTOT) and in patients not requiring LTOT. We studied 23 patients (14 males, 9 females; median age 71, range 60-84 yrs) with COPD who received LTOT using oxygen concentrators (LTOT group). We also studied a control group of 19 patients (14 males, 5 females; median age 72, range 62-75 yrs) with COPD but without severe hypoxaemia (non-LTOT group). We found no significant difference between groups in health status using the St George's Respiratory Questionnaire (SGRQ). Median Nottingham Extended Activities of Daily Living (EADL) total scores were: LTOT group 10, non-LTOT 17; (p=0.01). Significant correlations (p<0.001) with Nottingham EADL score were found for Hospital Anxiety and Depression (HAD) score (rho=0.59), SGRQ Total score (rho=0.65) and percentage predicted forced expiratory volume in one second (FEV1) (rho=0.66). In conclusion, in patients with severe chronic obstructive pulmonary disease and broadly similar health status, those using long-term oxygen therapy were less independent in activities of daily living than those not requiring long-term oxygen therapy. Reduced independence in activities of daily living is, however, associated with the extent of airflow limitation, depression and poor health status, and does not, therefore, appear to be simply a result of restriction in movements imposed by the stationary device.
在重度慢性阻塞性肺疾病（COPD）且使用长期氧疗（LTOT）的患者中，很少有研究调查其日常生活活动（ADL）情况。我们研究了使用长期氧疗的患者与无需长期氧疗的患者在日常生活活动、生活质量、情绪状态和气道阻塞之间的关系。我们研究了23例使用氧气浓缩器进行长期氧疗的慢性阻塞性肺疾病患者（14例男性，9例女性；中位年龄71岁，范围60 - 84岁）（长期氧疗组）。我们还研究了19例慢性阻塞性肺疾病但无严重低氧血症的对照组患者（14例男性，5例女性；中位年龄72岁，范围62 - 75岁）（非长期氧疗组）。使用圣乔治呼吸问卷（SGRQ）评估，我们发现两组在健康状况方面无显著差异。诺丁汉扩展日常生活活动（EADL）总分中位数为：长期氧疗组10分，非长期氧疗组17分；（p = 0.01）。医院焦虑抑郁量表（HAD）评分（rho = 0.59）、SGRQ总分（rho = 0.65）和一秒用力呼气容积（FEV1）预测值百分比（rho = 0.66）与诺丁汉EADL评分显著相关（p < 0.001）。总之，在健康状况大致相似的重度慢性阻塞性肺疾病患者中，使用长期氧疗的患者在日常生活活动中的独立性低于无需长期氧疗的患者。然而，日常生活活动独立性降低与气流受限程度、抑郁和健康状况不佳有关，因此，这似乎并非仅仅是固定设备限制活动所致。
