Impact of severe acute respiratory syndrome (SARS) on pulmonary function, functional capacity and quality of life in a cohort of survivors
Impact of severe acute respiratory syndrome (SARS) on pulmonary function, functional capacity and quality of life in a cohort of survivors
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DOI：
10.1136/thx.2004.030205
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发表时间：
2005-05-01
期刊：
影响因子：
10
通讯作者：
Sung, JJY
中科院分区：
文献类型：
--
作者：
Hui, DS;Joynt, GM;Sung, JJY
目的：为探讨严重急性呼吸综合征（SARS）对肺功能、运动能力和健康相关生活质量（HRQoL.Methods）的影响，对110例确诊SARS的幸存者在症状发作后3个月和6个月分别在香港威尔斯亲王医院进行评估。评估包括肺容量（TLC、VC、RV、FRC）、肺量测定（FVC，FEV 1），一氧化碳转移因子（根据血红蛋白调整TLCO）、吸气和呼气呼吸肌强度（Pimax和Pemax）、6分钟步行距离（6 MWD）、胸片和SF-36问卷的HRQoL。共有44名男性和66名女性，平均（SD）年龄为35.6（9.8）岁，体重指数为23.1（4.8）kg/m2。其中70人（64%）是医护人员。6个月时，33例受试者（30%）的胸片异常; 4例（3.6%）、8例（7.4%）和17例（15.5%）患者的FVC、TLC和TLCO低于预测值的80%; 15例（13.9%）和24例（22.2%）患者的Pimax和Pemax值分别低于80 cm H2O。6 MWD从3个月时的平均（SD）464（83）m增加到502（95）m（95% CI 22至54 m，p< 0.001），但结果低于相同年龄组的正常对照。6个月时HRQoL受损。需要ICU入院的患者（n = 31）有显着降低FVC，TLC，TLCO比那些没有。结论：SARS幸存者的运动能力和健康状况是相当低的，比正常人群在6个月。在15.5%的幸存者中观察到气体交换表面积显著受损。功能障碍似乎与肺功能损害的程度不成比例，并且可能与肌肉失调和类固醇肌病等其他因素有关。
Objective: To examine the impact of severe acute respiratory syndrome (SARS) on pulmonary function, exercise capacity, and health-related quality of life (HRQoL) among survivors.Methods: 110 survivors with confirmed SARS were evaluated at the Prince of Wales Hospital, HK at the end of 3 and 6 months after symptom onset. The assessment included lung volumes (TLC, VC, RV, FRC), spirometry (FVC, FEV1), carbon monoxide transfer factor (TLCO adjusted for haemoglobin), inspiratory and expiratory respiratory muscle strength (Pimax and Pemax), 6 minute walk distance (6MWD), chest radiographs, and HRQoL by SF-36 questionnaire.Results: There were 44 men and 66 women with a mean (SD) age of 35.6 (9.8) years and body mass index of 23.1 (4.8) kg/m(2). Seventy (64%) were healthcare workers. At 6 months 33 subjects (30%) had abnormal chest radiographs; four (3.6%), eight (7.4%), and 17 (15.5%) patients had FVC, TLC, and TLCO below 80% of predicted values; and 15 (13.9%) and 24 (22.2%) had Pimax and Pemax values below 80 cm H2O, respectively. The 6MWD increased from a mean ( SD) of 464 ( 83) m at 3 months to 502 ( 95) m (95% CI 22 to 54 m, p< 0.001), but the results were lower than normal controls in the same age groups. There was impairment of HRQoL at 6 months. Patients who required ICU admission (n = 31) had significantly lower FVC, TLC, and TLCO than those who did not.Conclusion: The exercise capacity and health status of SARS survivors was considerably lower than that of a normal population at 6 months. Significant impairment in surface area for gas exchange was noted in 15.5% of survivors. The functional disability appears out of proportion to the degree of lung function impairment and may be related to additional factors such as muscle deconditioning and steroid myopathy.