• 1 哈爾濱醫(yī)科大學第一臨床醫(yī)學院呼吸內(nèi)科( 黑龍江哈爾濱 150001) ;;
  • 2 哈爾濱市疾病控制中心( 黑龍江哈爾濱 150001);

目的  比較COPD 患者BODE 指數(shù)( B 為體重指數(shù), O 為氣流阻塞, D 為呼吸困難, E 為運動能力) 與GOLD 分級用于評估病情嚴重程度的價值, 探討B(tài)ODE 指數(shù)與患者生活質(zhì)量的相關性。方法  選擇COPD 穩(wěn)定期患者100 例。采用圣喬治呼吸問卷( SGRQ) 評價患者的生活質(zhì)量并對其進行肺功能測試。計算BODE 指數(shù)及其各項目的評分, 包括體重指數(shù)( BMI) 、氣流阻塞程度( FEV1%pred) 、呼吸困難( MMRC) 、運動能力( 6MWD) 。受試者分別根據(jù)GOLD 分級標準和BODE 指數(shù)分為四組, 通過SGRQ 評分對GOLD 分級和BODE 指數(shù)進行比較。結果  BODE 指數(shù)與COPD患者的SGRQ 總分、問卷各部分評分均呈顯著的相關性( P  lt;0. 01) 。BODE 指數(shù)可以較好地預測患者的生活質(zhì)量, 能解釋41. 3% 的SGRQ 總分( P  lt;0. 01) 。然而GOLD 分級僅與SGRQ 活動能力分值呈相關性( P  lt;0. 05) , 同SGRQ 其他評分并無相關。根據(jù)BODE 指數(shù)劃分的各組患者中, SGRQ 總分和其他部分評分均有明顯差異( P  lt;0. 01) , 但是按照GOLD分級標準劃分的各組患者中, 除活動能力分值外( P  lt;0. 01) , 其余各組的SGRQ 總分和各部分評分無明顯差異。結論  BODE 評分系統(tǒng)與GOLD 分級相比, 能更好的評價不同嚴重程度COPD 患者病情與其生活質(zhì)量的相關性。

引用本文： 楊帆,霍建民,王冬杰,王健. COPD 患者病情嚴重程度與生活質(zhì)量的相關性研究. 中國呼吸與危重監(jiān)護雜志, 2010, 9(5): 471-475. doi: 復制

1. Pauwels RA, Buist AS, Calverley PM, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: NHLBI /WHO Global Initiative for Chronic Obstructive Lung Disease ( GOLD ) Workshop summary. Am J Respir Crit Care Med, 2001, 163: 1256 -1276 .
2. Murray CJ, Lopez AD. Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet, 1997, 349: 1269 -1276.
3. 徐鷗, 郝青林, 李銳潔, 等. 圣喬治呼吸問卷對慢性塞性肺疾病患者生活質(zhì)量差異的調(diào)查. 昆明醫(yī)學院學報, 2008, 29: 71-75.
4. Cel1 i BR, Cote CG, Marin JM, et al. The body-mass index, airflow obstruction, dyspnea and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med, 2004, 350: 1005 -1012.
5. Medinas Amorós M, Mas-Tous C, Renom-Sotorra F, et al. Healthrelated quality of life is associated with COPD severity: a comparison between the GOLD staging and the BODE index. Chron Respir Dis, 2009, 6 : 75-80.
6. 中華醫(yī)學會呼吸病學分會慢性阻塞性肺疾病組. 慢性阻塞性肺疾病診治指南. 中華結核和呼吸雜志, 2002, 25: 453 -459.
7. Celli BR, MacNee W, Arusti A, et al. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J, 2004, 23: 932-946 .
8. Jone PW, Quirk FH, Baveystock CM, et al. The St George′s Respiratory Questionnaire. Respir Med, 1991, 85 : 25-31.
9. Mahler DA, Weinberg DH, Wells CK, et al. The measurement of dyspnea: contents, interobserver agreement, and physiologic correlates of two new clinical indexes. Chest, 1984 , 85: 751-758.
10. Ozalevli S, Ozden A, Itil O, et al. Comparison of the Sit-to-Stand Test with 6min walk test in patients with chronic obstructive pulmonary disease. Respir Med, 2007, 101: 286 -293.
11. Jones PW, Quirk FH, Baveystock CM, et al. A self-complete measure of health status for chronic airflow limitation: the St.George’s respiratory questionnaire. Am Rev Respir Dis, 1992, 145 :1321-1327.
12. Alsaeedi A, Sin DD, McAlister FA, et al. The effects of inhaled corticosteroids in chronic obstructive pulmonary disease: a systematic review of randomized placebo-controlled trials. Am J Med, 2002, 113: 59-65.
13. O′Donnell DE, Lam M, Webb KA, et al. Measurement of symptoms, lung hyperinflation, and endurance during exercise in chronic obstructive pulmonary disease. AmJ Respir Crit Care Med,1998, 158: 1557-1565.
14. Stephen I. Looking at the patient: approaching the problem of COPD. N Engl J Med, 2004, 350 : 965-966.
15. Katsura H, Yamada K, Kida K, et al. Both generic and disease specific health-related quality of life are deteriorated in patients with underweight COPD. Respir Med, 2005, 99: 624 -630.
16. Nishimura K, Lzumi T, Tsukino M, et al. Dyspnea is better predictor of 5-year survival than airway obstructive in patients with COPD.Chest, 2002, 121: 1434 -1440 .
17. 雷玲, 鐘小寧, 何志義. 慢性阻塞性肺疾病患者BODE 指數(shù)與生活質(zhì)量的相關性研究. 中國呼吸與危重監(jiān)護雜志, 2007, 6 : 261 -264.
18. Cote CG, Dordelly LJ, Celli BR, et al. Impact of exacerbations on patient-centered outcomes. Chest, 2007 , 131: 696-704 .
  1. 1. Pauwels RA, Buist AS, Calverley PM, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: NHLBI /WHO Global Initiative for Chronic Obstructive Lung Disease ( GOLD ) Workshop summary. Am J Respir Crit Care Med, 2001, 163: 1256 -1276 .
  2. 2. Murray CJ, Lopez AD. Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet, 1997, 349: 1269 -1276.
  3. 3. 徐鷗, 郝青林, 李銳潔, 等. 圣喬治呼吸問卷對慢性塞性肺疾病患者生活質(zhì)量差異的調(diào)查. 昆明醫(yī)學院學報, 2008, 29: 71-75.
  4. 4. Cel1 i BR, Cote CG, Marin JM, et al. The body-mass index, airflow obstruction, dyspnea and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med, 2004, 350: 1005 -1012.
  5. 5. Medinas Amorós M, Mas-Tous C, Renom-Sotorra F, et al. Healthrelated quality of life is associated with COPD severity: a comparison between the GOLD staging and the BODE index. Chron Respir Dis, 2009, 6 : 75-80.
  6. 6. 中華醫(yī)學會呼吸病學分會慢性阻塞性肺疾病組. 慢性阻塞性肺疾病診治指南. 中華結核和呼吸雜志, 2002, 25: 453 -459.
  7. 7. Celli BR, MacNee W, Arusti A, et al. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J, 2004, 23: 932-946 .
  8. 8. Jone PW, Quirk FH, Baveystock CM, et al. The St George′s Respiratory Questionnaire. Respir Med, 1991, 85 : 25-31.
  9. 9. Mahler DA, Weinberg DH, Wells CK, et al. The measurement of dyspnea: contents, interobserver agreement, and physiologic correlates of two new clinical indexes. Chest, 1984 , 85: 751-758.
  10. 10. Ozalevli S, Ozden A, Itil O, et al. Comparison of the Sit-to-Stand Test with 6min walk test in patients with chronic obstructive pulmonary disease. Respir Med, 2007, 101: 286 -293.
  11. 11. Jones PW, Quirk FH, Baveystock CM, et al. A self-complete measure of health status for chronic airflow limitation: the St.George’s respiratory questionnaire. Am Rev Respir Dis, 1992, 145 :1321-1327.
  12. 12. Alsaeedi A, Sin DD, McAlister FA, et al. The effects of inhaled corticosteroids in chronic obstructive pulmonary disease: a systematic review of randomized placebo-controlled trials. Am J Med, 2002, 113: 59-65.
  13. 13. O′Donnell DE, Lam M, Webb KA, et al. Measurement of symptoms, lung hyperinflation, and endurance during exercise in chronic obstructive pulmonary disease. AmJ Respir Crit Care Med,1998, 158: 1557-1565.
  14. 14. Stephen I. Looking at the patient: approaching the problem of COPD. N Engl J Med, 2004, 350 : 965-966.
  15. 15. Katsura H, Yamada K, Kida K, et al. Both generic and disease specific health-related quality of life are deteriorated in patients with underweight COPD. Respir Med, 2005, 99: 624 -630.
  16. 16. Nishimura K, Lzumi T, Tsukino M, et al. Dyspnea is better predictor of 5-year survival than airway obstructive in patients with COPD.Chest, 2002, 121: 1434 -1440 .
  17. 17. 雷玲, 鐘小寧, 何志義. 慢性阻塞性肺疾病患者BODE 指數(shù)與生活質(zhì)量的相關性研究. 中國呼吸與危重監(jiān)護雜志, 2007, 6 : 261 -264.
  18. 18. Cote CG, Dordelly LJ, Celli BR, et al. Impact of exacerbations on patient-centered outcomes. Chest, 2007 , 131: 696-704 .