Hajiro T, Nishimura K, Tsukino M, Ikeda A, Koyama H, Izumi T
Chest Disease Research Institute, Kyoto University, Japan.
Am J Respir Crit Care Med. 1998 Mar;157(3 Pt 1):785-90. doi: 10.1164/ajrccm.157.3.9703055.
Three disease-specific, health-related quality of life (HRQL) questionnaires have been introduced to assess patients with chronic obstructive pulmonary disease (COPD): the St. George's Respiratory Questionnaire (SGRQ), the Breathing Problems Questionnaire (BPQ), and the Chronic Respiratory Disease Questionnaire (CRQ). The purpose of the present study was to make comparisons between the SGRQ, the BPQ, and the CRQ in their discriminative properties, and to clarify the characteristics of each questionnaire. One hundred forty-three patients with mild to severe COPD completed pulmonary function tests, progressive cycle ergometer testing for exercise capacity, assessment of dyspnea, anxiety, and depression, and assessment of HRQL. The frequency distributions of the questionnaire scores showed that the SGRQ and the CRQ were normally distributed and that the BPQ was skewed toward low scores. Relationships between all dimensions of the three questionnaires were significant (correlation coefficients [Rs] = 0.74 to 0.86). The three questionnaires had significant but weak correlations (Rs = -0.24 to -0.36) with some physiologic variables (VC, FEV1, and DL(CO)/VA) and mild to moderate correlations with exercise capacity and assessment of dyspnea, anxiety, and depression. Stepwise multiple regression analyses revealed that the Baseline Dyspnea Index (BDI) score, anxiety by the Hospital Anxiety Depression Scale (HAD), and maximal oxygen uptake (VO2max) accounted for 61% of the variance in the SGRQ and that the BDI and anxiety of the HAD accounted for 53 and 49% of the variance in the BPQ and the CRQ, respectively. Dyspnea and psychologic status impacted the HRQL in patients with COPD. Although no substantial differences between the SGRQ, the BPQ, and the CRQ were evident in the correlations with physiologic parameters and the influential factors, the BPQ was found to be less discriminatory than the SGRQ and the CRQ in evaluating HRQL cross-sectionally.
已引入三种特定疾病的、与健康相关的生活质量（HRQL）问卷来评估慢性阻塞性肺疾病（COPD）患者：圣乔治呼吸问卷（SGRQ）、呼吸问题问卷（BPQ）和慢性呼吸系统疾病问卷（CRQ）。本研究的目的是比较SGRQ、BPQ和CRQ的区分特性，并阐明每种问卷的特点。143例轻度至重度COPD患者完成了肺功能测试、运动能力的渐进式循环测力计测试、呼吸困难、焦虑和抑郁评估以及HRQL评估。问卷得分的频率分布显示，SGRQ和CRQ呈正态分布，而BPQ向低分倾斜。三种问卷所有维度之间的关系均显著（相关系数[Rs]=0.74至0.86）。这三种问卷与一些生理变量（肺活量[VC]、第一秒用力呼气容积[FEV1]和一氧化碳弥散量/肺泡通气量[DL(CO)/VA]）有显著但较弱的相关性（Rs=-0.24至-0.36），与运动能力以及呼吸困难、焦虑和抑郁评估有轻度至中度相关性。逐步多元回归分析显示，基线呼吸困难指数（BDI）得分、医院焦虑抑郁量表（HAD）评估的焦虑以及最大摄氧量（VO2max）分别解释了SGRQ中61%的方差，BDI和HAD评估的焦虑分别解释了BPQ和CRQ中53%和49%的方差。呼吸困难和心理状态影响COPD患者的HRQL。尽管SGRQ、BPQ和CRQ在与生理参数和影响因素的相关性方面没有明显差异，但在横断面评估HRQL时，发现BPQ的区分度低于SGRQ和CRQ。
