Impact on patients' health status following early identification of a COPD exacerbation
Impact on patients' health status following early identification of a COPD exacerbation
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DOI：
10.1183/09031936.00166606
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发表时间：
2007-11-01
影响因子：
24.3
通讯作者：
Ruberto, G.
中科院分区：
文献类型：
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作者：
Bourbeau, J.;Ford, G.;Ruberto, G.
当前研究旨在评估慢性阻塞性肺病（AECOPD）急性加重期间对患者健康状况的影响。共421例COPD患者入组了一项多中心、单组研究，随访期为6个月。患者每天两次吸入两吸信必可200都保（R）。在导入期前、基线和1、3和6个月时对患者进行评估。指导患者报告呼吸道症状持续>24小时的变化。这就定义了AECOPD。除初始呼叫外，还在第5-7天和第12-14天完成了St乔治呼吸问卷（SGRQ）、COPD控制问卷（CCQ）、医学研究理事会（MRC）呼吸困难量表和日常生活活动（ADL）。一组176例患者报告了至少1例AECOPD。急性加重与统计学显著平均变化相关发作时SGRQ活性和影响领域（恶化）（平均值+/- SD 12.1 +/- 18.1和14.0 +/- 15.2），第一周（9.8 +/- 19.0和9.4 +/- 16.6）和第二周（3.1 +/- 15.5和3.3 +/- 14.7）。在早期识别后，71%的患者SGRQ影响评分出现临床显著恶化，AECOPD第一周和第二周分别为55%和37%。急性加重严重影响健康状况。目前的研究提供了关于慢性阻塞性肺疾病急性加重期间健康状况变化的有价值的信息，可用于未来评估治疗干预的试验。
The current study aimed to assess the impact on patient health status during an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). A total of 421 COPD patients were enrolled in a multicentre, single-arm study with a 6-month observational follow-up period. Patients received two inhalations of Symbicort 200 Turbuhaler (R) twice a day. Patients were assessed before the run-in period, at baseline and at 1, 3 and 6 months. Patients were instructed to report a change in respiratory symptoms lasting >24 h. This defined an AECOPD. In addition to the initial call, the St George's Respiratory Questionnaire (SGRQ), COPD Control Questionnaire (CCQ), Medical Research Council (MRC) dyspnoea scale and activities of daily living (ADL) were completed at 5-7 and 12-14 days. A group of 176 patients reported at least one AECOPD. Exacerbations were associated with statistically significant mean changes (worsening) in the SGRQ activity and impact domains at onset (mean +/- SD 12.1 +/- 18.1 and 14.0 +/- 15.2), during the first (9.8 +/- 19.0 and 9.4 +/- 16.6) and second weeks (3.1 +/- 15.5 and 3.3 +/- 14.7). Clinically significant deterioration in SGRQ impact scores was shown in 71% of patients following early identification, with 55 and 37% during the first and second weeks of an AECOPD, respectively. Acute exacerbation severely impacts on health status. The current study provides valuable information on the change in health status during an acute exacerbation of chronic obstructive pulmonary disease that can be utilised for future trials that evaluate therapeutic intervention.