Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease
Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease
复制标题
医学研究委员会（MRC）呼吸困难量表作为慢性阻塞性肺病患者残疾度量标准的实用性
DOI：
10.1136/thx.54.7.581
复制
发表时间：
1999-07-01
期刊：
影响因子：
10
通讯作者：
Wedzicha, JA
中科院分区：
文献类型：
--
作者：
Bestall, JC;Paul, EA;Wedzicha, JA
慢性阻塞性肺疾病（COPD）的分类方法很大程度上依赖于肺功能测定，但残疾与肺功能测定的相关性很弱。随着肺康复使用的增加，需要一种简单且标准化的COPD残疾分类方法。本研究探讨了有效性的医学研究理事会（MRC）呼吸困难的规模为这个purpose. Methods-100例COPD患者被招募从门诊肺康复计划。评估包括MRC呼吸困难量表、肺功能测定、血气分析、穿梭行走试验和运动前后感觉呼吸困难的博格评分。使用St乔治呼吸问卷（SGRQ）和慢性呼吸问卷（CRQ）评估健康状况。诺丁汉扩展日常生活活动（EADL）评分和医院焦虑和抑郁（HAD）score.Results-Of患者的研究，32被归类为MRC 3级呼吸困难，34 MRC 4级呼吸困难，34 MRC 5级呼吸困难。MRC 1级和2级呼吸困难患者未纳入本研究。MRC等级与穿梭距离、SGRQ和CRQ评分、情绪状态和EADL之间存在显着相关性。第一秒用力呼气量（FEV 1）与MRC分级无关。多元Logistic回归分析显示，残疾的决定因素似乎随着残疾程度的不同而不同。MRC等级3和4之间的显着协变量是运动表现，SGRQ和抑郁评分，而等级4和5之间的运动表现和年龄的主要determinations. Conclusions MRC呼吸困难量表是一个简单而有效的方法来分类COPD患者在他们的残疾，可用于补充FEV 1在COPD严重程度的分类。
Background-Methods of classifying chronic obstructive pulmonary disease (COPD) depend largely upon spirometric measurements but disability is only weakly related to measurements of lung function. With the increased use of pulmonary rehabilitation, a need has been identified for a simple and standardised method of categorising disability in COPD. This study examined the validity of the Medical Research Council (MRC) dyspnoea scale for this purpose.Methods-One hundred patients with COPD were recruited from an outpatient pulmonary rehabilitation programme. Assessments included the MRC dyspnoea scale, spirometric tests, blood gas tensions, a shuttle walking test, and Borg scores for perceived breathlessness before and after exercise. Health status was assessed using the St George's Respiratory Questionnaire (SGRQ) and Chronic Respiratory Questionnaire (CRQ). The Nottingham Extended Activities of Daily Living (EADL) score and Hospital Anxiety and Depression (HAD) score were also measured.Results-Of the patients studied, 32 were classified as having MRC grade 3 dyspnoea, 34 MRC grade 4 dyspnoea, and 34 MRC grade 5 dyspnoea. Patients with MRC grades 1 and 2 dyspnoea were not included in the study. There was a significant association between MRC grade and shuttle distance, SGRQ and CRQ scores, mood state and EADL. Forced expiratory volume in one second (FEV1) was not associated with MRC grade. Multiple logistic regression showed that the determinants of disability appeared to vary with the level of disability. Between MRC grades 3 and 4 the significant covariates were exercise performance, SGRQ and depression score, whilst between grades 4 and 5 exercise performance and age were the major determinants.Conclusions-The MRC dyspnoea scale is a simple and valid method of categorising patients with COPD in terms of their disability that could be used to complement FEV1 in the classification of COPD severity.