Evaluation of psychological and physiological predictors of fatigue in patients with COPD.
Evaluation of psychological and physiological predictors of fatigue in patients with COPD.
复制标题
DOI：
10.1186/1471-2466-9-47
复制
发表时间：
2009-10-21
影响因子：
3.1
通讯作者：
Garrod R
中科院分区：
文献类型：
--
作者：
Lewko A;Bidgood PL;Garrod R
COPD患者的疲劳损害功能状态;然而，很少有研究检查这种症状的机制途径。本研究的目的是比较COPD患者和年龄匹配的健康受试者之间的疲劳，并确定COPD疲劳的预测因素。74例COPD患者（平均年龄69.9（49-87）岁，平均（SD）%预测FEV 1 46.5（20.0）%和FEV 1/FVC比值0.45（0.13））和35例健康受试者（平均年龄67.1（50-84）岁）完成了多维疲劳量表（MFI 20）。患者评估包括抑郁（HADS）、肺功能、BMI、肌力、递增穿梭步行试验（ISWT）、运动血氧饱和度（SpO 2）、博格呼吸困难（CR-10）和劳力（RPE）。记录血清白细胞介素6（IL-6）水平。研究各组之间MFI 20的差异，并使用逻辑回归确定疲劳的预测因素。COPD组与健康对照组相比，MFI 20各维度均有显著性差异（p < 0.01）。仅在选定的维度上，根据GOLD和呼吸困难分期进行分类时存在显著差异。全身疲劳的预测因子为抑郁、肌力和末次SpO 2（R2 = .62）;体力疲劳：抑郁、FEV 1预测值%、ISWT和年龄（R2 = .57）;活动减少：FEV 1预测值%、BMI和抑郁（R2 = 0.36）;动机降低：RPE、抑郁和终点SpO 2（R2 = 0.37）;精神疲劳：抑郁和终点SpO 2（R2 = 0.38）。COPD组疲劳各维度均高于健康老年人。预测因素根据所调查的疲劳的尺寸而不同。COPD-RF是一种需要进一步考虑的多组分症状。
Fatigue in COPD impairs functional status; however there are few studies examining mechanistic pathways of this symptom. The aims of this study are to compare fatigue between COPD patients and healthy age-matched subjects, and to identify predictors of fatigue in COPD. Seventy four COPD patients, mean age 69.9 (49-87) yrs, mean (SD) % predicted FEV1 46.5 (20.0) % and FEV1/FVC ratio 0.45 (0.13) and 35 healthy subjects, mean age 67.1 (50-84) yrs completed the Multidimensional Fatigue Inventory (MFI 20). Patients' assessment included Depression (HADS), lung function, BMI, muscle strength, incremental shuttle walk test (ISWT), exercise oxygen saturation (SpO2), Borg breathlessness (CR-10) and exertion (RPE). Serum level of Interleukin 6 (IL-6) was recorded. Differences in MFI 20 between groups were examined and predictors of fatigue identified using logistic regression. Significant differences (p < 0.01) were found between the COPD and healthy subjects for all MFI 20 dimensions. There were significant differences when classified according to GOLD and dyspnoea stages for selected dimensions only. Predictors of General Fatigue were depression, muscle strength and end SpO2 (R2 = .62); of Physical Fatigue: depression, % predicted FEV1, ISWT and age (R2 = .57); Reduced Activity: % predicted FEV1, BMI and depression (R2 = .36); Reduced Motivation: RPE, depression and end SpO2 (R2 = .37) and Mental Fatigue: depression and end SpO2 (R2 = .38). All dimensions of fatigue were higher in COPD than healthy aged subjects. Predictive factors differ according to the dimension of fatigue under investigation. COPD-RF is a multi component symptom requiring further consideration.