Analysis of clinical methods used to evaluate dyspnea in patients with chronic obstructive pulmonary disease
Analysis of clinical methods used to evaluate dyspnea in patients with chronic obstructive pulmonary disease
复制标题
DOI：
10.1164/ajrccm.158.4.9802091
复制
发表时间：
1998-10-01
影响因子：
24.7
通讯作者：
Izumi, T
中科院分区：
文献类型：
--
作者：
Hajiro, T;Nishimura, K;Izumi, T
当呼吸困难必须在临床上进行评估时，有三种评估方法：使用临床呼吸困难评级（如改良医学研究理事会（MRC）、基线呼吸困难指数（BDI）和氧耗图（OCD））测量日常生活活动中的呼吸困难;使用博格量表测量运动期间的呼吸困难;使用疾病特异性问卷，如圣乔治呼吸问卷（SGRQ）和慢性呼吸疾病问卷（CRQ），评估呼吸困难对健康相关生活质量（HRQoL）的影响。本横断面研究的目的是通过应用因子分析阐明呼吸困难评分和HRQoL问卷之间的关系。161例轻度至重度CORD患者完成了肺功能检查、渐进式踏车运动能力测试、呼吸困难评估、HRQoL、焦虑和抑郁。因子分析表明，MRC、BDI、OCD、SGRQ的活动性和CRQ的呼吸困难被归为同一因子，这5个指标的频数分布直方图显示出几乎相同的分布。最大运动量结束时的博格量表被认为是一个不同的因素。SCRQ中的MRC、BDI、OCD和活动以及CRQ中的呼吸困难与生理数据表现出相同的相关模式，并且它们与FEV 1（相关系数[Rs] = 0.31至0.48）和最大摄氧量（Rs = 0.46至0.60）具有显著关系。疾病特异性HRQoL问卷、SGRQ和CRQ。其包含用于评估呼吸困难的特定维度，可以替代横截面评估中的临床呼吸困难等级。运动结束时的呼吸困难等级可以提供关于呼吸困难的进一步信息。
When dyspnea must be assessed clinically, there are three methods of assessment: the measurement of dyspnea with activities of daily living using clinical dyspnea ratings such as the modified Medical Research Council (MRC), the Baseline Dyspnea Index (BDI), and the Oxygen Cost Diagram (OCD); the measurement of dyspnea during exercise using the Borg scale; to assess the influence of dyspnea on health-related quality of life (HRQoL) using disease-specific questionnaires such as the St. George's Respiratory Questionnaire (SGRQ) and the Chronic Respiratory Disease Questionnaire (CRQ). The purpose of the present cross-sectional study was to clarify relationships between dyspnea ratings and HRQoL questionnaires by applying factor analysis. One hundred sixty-one patients with mild to severe CORD completed pulmonary function tests, progressive cycle ergometer testing for exercise capacity, assessment of dyspnea, HRQoL, anxiety, and depression. Factor analysis demonstrated that the MRC, BDI, OCD, and Activity of the SGRQ, and Dyspnea of the CRQ were grouped into the same factor, and the frequency distribution histograms of these five measures showed virtually the same distribution. The Borg scale at the end of maximum exercise was found to be a different factor. The MRC, BDI, OCD, and Activity in the SCRQ, and Dyspnea in the CRQ demonstrated the same pattern of correlation with physiologic data, and they had significant relationships with FEV1 (correlation coefficients [Rs] = 0.31 to 0.48) and maximal oxygen uptake (Rs = 0.46 to 0.60). Disease-specific HRQoL questionnaires, the SGRQ and the CRQ. which contain a specific dimension for evaluating dyspnea, may be substituted for clinical dyspnea ratings in a cross-sectional assessment. Dyspnea rating at the end of exercise may provide further information regarding dyspnea.