两种通用工具和两种哮喘特异性工具的鉴别特征:与轻度哮喘患者症状、支气管扩张剂使用及肺功能的关系
Discriminative aspects of two generic and two asthma-specific instruments: relation with symptoms, bronchodilator use and lung function in patients with mild asthma.
作者信息
van der Molen T, Postma D S, Schreurs A J, Bosveld H E, Sears M R, Meyboom de Jong B
机构信息
Department of General Practice, University of Groningen, The Netherlands.
出版信息
Qual Life Res. 1997 May;6(4):353-61. doi: 10.1023/a:1018483310277.
The objective of this study was to compare the two most frequently used asthma-specific quality of life (QOL) questionnaires and two generic QOL questionnaries with clinical data in order to establish their ability to discriminate in asthma severity, also referred to as cross-sectional construct validity. We conducted a multicentre, randomized, placebo-controlled study investigating the long-term effects of the long-acting beta 2-agonist formoterol in asthma patients using inhaled corticosteroids and short-acting beta 2-agonists. Before randomization, the peak expiratory flow (PEF) and use of beta 2-agonists for relief of symptoms were recorded twice daily for 1 month. At the end of the run-in period, the forced expiratory volume in 1 s (FEV1), airway hyper-responsiveness (PC20 methacholine) and QOL were measured, using two asthma-specific questionnaires, the Asthma Quality of Life Questionnaire (AQLQ) and the Living with Asthma Quality of Life Questionnaire (LWAQ), as well as two generic questionnaires, the Short Form 36 (SF-36) and the Psychological General Well Being (PGWB) index. The quality of life of the patients (n = 110) was only mildly impaired. The mean symptom score was 3.6 on a scale of 0-21 and the mean FEV1 was 65% of that predicted. The correlations between the QOL parameters and objective measures of asthma severity, such as the FEV1, PEF and PC20, were low (0.01-0.37). The correlations between the QOL parameters and subjective measures of asthma severity, such as symptom scores (range 0.26-0.65) and beta 2-agonist use for the relief of symptoms (0.09-0.39), were higher. The correlations of the activity and symptoms domains of the AQLQ with diary-obtained symptom scores were r = 0.50 (p < 0.0001) and r = 0.65 (p < 0.0001), respectively. The correlation between the physical construct of the LWAQ and symptom scores was r = 0.42 (p < 0.001) and that between the physical sumscore of the SF-36 and symptom scores was r = 0.50 (p < 0.001). The correlation between the PGWB and symptom scores was r = 0.41 (p < 0.001). The relation between the FEV1, PEF and PC20 and QOL was very low. The QOL measurements related well to the symptom scores. The AQLQ had a better cross-sectional construct validity than the LWAQ. The cross-sectional construct validity of the SF-36 was surprisingly high for this group of patients and the SF-36 performed better than the PGWB and LWAQ.
本研究的目的是比较两种最常用的哮喘特异性生活质量(QOL)问卷和两种通用QOL问卷与临床数据,以确定它们区分哮喘严重程度的能力,也称为横断面结构效度。我们进行了一项多中心、随机、安慰剂对照研究,调查长效β2受体激动剂福莫特罗对使用吸入性糖皮质激素和短效β2受体激动剂的哮喘患者的长期影响。在随机分组前,每日两次记录呼气峰值流速(PEF)和使用β2受体激动剂缓解症状的情况,持续1个月。在导入期结束时,使用两种哮喘特异性问卷,即哮喘生活质量问卷(AQLQ)和哮喘患者生活质量问卷(LWAQ),以及两种通用问卷,即简明健康状况调查量表(SF-36)和心理总体幸福感(PGWB)指数,测量1秒用力呼气容积(FEV1)、气道高反应性(PC20乙酰甲胆碱)和生活质量。患者(n = 110)的生活质量仅受到轻度损害。症状平均评分为3.6(0 - 21分制),FEV1平均为预测值的65%。生活质量参数与哮喘严重程度的客观指标(如FEV1、PEF和PC20)之间的相关性较低(0.01 - 0.37)。生活质量参数与哮喘严重程度的主观指标(如症状评分(范围0.26 - 0.65)和使用β2受体激动剂缓解症状情况(0.09 - 0.39))之间的相关性较高。AQLQ的活动和症状领域与日记记录的症状评分之间的相关性分别为r = 0.50(p < 0.0001)和r = 0.65(p < 0.0001)。LWAQ的身体结构与症状评分之间的相关性为r = 0.42(p < 0.001),SF-36的身体总分与症状评分之间的相关性为r = 0.50(p < 0.001)。PGWB与症状评分之间的相关性为r = 0.41(p < 0.001)。FEV1、PEF和PC20与生活质量之间的关系非常低。生活质量测量与症状评分密切相关。AQLQ的横断面结构效度优于LWAQ。对于该组患者,SF-36的横断面结构效度出奇地高,且SF-36的表现优于PGWB和LWAQ。