慢性阻塞性肺疾病患者SGRQ评分与肺功能的相关性及影响因素  

Relationship between SGRQ score and pulmonary function and its influencing factors in patients with chronic obstructive pulmonary disease

作　　者：刘珞[1] 杜毅鹏[1] 贺蓓[1] 

机构地区：[1]北京大学第三医院呼吸科,北京100191

出　　处：《中华医学杂志》2011年第22期1533-1537,共5页National Medical Journal of China

基　　金：国家自然科学基金（30770939）;教育部博士点基金（20090001110093）

摘　　要：目的探讨圣乔治问卷（SGRQ）与慢性阻塞性肺疾病（COPD）患者肺功能的相关关系及其影响因素。方法对63例稳定期COPD患者进行SGRQ评分及肺功能测定并对结果进行相关性分析，按GOLD分级分为两组，Ⅱ级（中度）32例，Ⅲ和Ⅳ级（重度至极重度）31例，比较组间SGRQ评分差异；按年龄分为〈70岁组（n=31）和I〉70岁组（n=32），对组内肺功能和SGRQ评分进行相关性分析；同意参加治疗随访的36例患者随机分为两组，分别吸入沙美特罗／氟替卡松（50μg／500肛g，2次／d）及沙丁胺醇／异丙托溴胺（120μg/21μg，4次／d）治疗，随访3个月，最终完成随访共34例，分析治疗前后数据。结果按GOLD分级两组间SGRQ总分及各部分评分差异无统计学意义；〈70岁组用力肺活量占预计值百分比（FVC％）、第1秒用力呼气容积占预计值百分比（FEV，％）、呼气峰流量占预计值百分比（FEFMAX％）、慢肺活量占预计值百分比（SVC％）与SGRQ总分及症状、活动部分评分有轻至中度相关性（r=-0．341～-0．534），≥70岁组仅深吸气量占预计值百分比（IC％）与活动部分评分有一定相关关系（r=-0．412）；与沙丁胺醇／异丙托溴胺组相比，沙美特罗／氟替卡松组治疗后SGRQ评分较治疗前显著下降（P=0．001）。结论SGRQ评分结果受年龄因素影响。评价患者用药前后疗效时，SGRQ评分具有参考价值。Objective To study the correlation and influencing factors between the St. George respiratory questionnaire （SGRQ） and lung functions in chronic obstructive pulmonary disease （ COPD ） patients. Methods Sixty-three stable COPD patients received pulmonary function tests and SGRQ. A correlation analysis of the results was performed. They were divided into two groups according to GOLD （ global initiative for chronic obstructive lung disease） classification scheme, 32 patients were in stage II （moderate） and 31 in stages m and IV （severe ＆ very severe）. And the inter-group SGRQ scores were compared. According to age, they were divided into 〈 70 years group（ n = 31 ）and ≥ 70 years group （n = 32）. The correlations between the SGRQ score and pulmonary functions were analyzed in different age groups. Thirty-six patients willing to participate in treatment and a 3-month follow-up were randomly divided into two groups of treatment with either salmeteroL/fluticasone （50μg/500μg） （n = 18） or salbutamol/ ipratropium bromide （ 120μg/21μg） （n = 18 ）. The post-therapeutic changes of SGRQ score and pulmonary functions were analyzed. Results There were no significant differences in SGRQ total score and all section score between two groups according to GOLD classification scheme. There were mild to moderate correlations in the 〈 70 years group between lung functions including FVC% , FEV1% , FEFMAX% , SVC% and the SGRQ score including total score, symptoms section score and activity section score. The range of correlation coefficients was -0. 341 to -0. 534. However, the score only had some correlation with IC% in the ~〉70 years group. Compared with the salbutamol/ipratropium bromide treatment group, the SGRQ score of the salmeterol/fluticasone treatment group decreased significantly after therapy （ P = 0. 001 ） . Conclusion Influenced by age, the SGRQ score can be used to evaluate the clinical efficacy of medications in COPD patients.

关 键 词：肺疾病 慢性阻塞性 肺功能 圣乔治评分 年龄 

分 类 号：R563.05[医药卫生—呼吸系统]