稳定期慢性阻塞性肺疾病患者运动能力的影响因素分析  

Factors Associated with Exercise Capacity in Stable Chronic Obstructive Pulmonary Disease Patients

作　　者：林琳[1] 田景炜 颛孙永勋[1] 李建国[1] 陈瑞[1] LIN Lin TIAN Jing-wei ZHUAN-SUN Yong-xun LI Jian-guo CHEN Rui(Department of Respiration Comprehensive Department, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China)

机构地区：[1]中山大学孙逸仙纪念医院呼吸内科,广东广州510120 [2]中山大学孙逸仙纪念医院综合科,广东广州510120

出　　处：《中山大学学报（医学科学版）》2016年第6期950-955,共6页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技计划项目(2011B080701062);广东省自然科学基金(S2012010008623)

摘　　要：【目的】探讨影响稳定期慢性阻塞性肺疾病(COPD)患者运动能力的主要因素。【方法】检测109例稳定期COPD患者常规肺通气功能、股四头肌功能和在6 min步行试验(6MWT)前后深吸气量(IC)的变化,同时对所有受试者进行改良版英国医学研究会(m MRC)呼吸困难评分、圣乔治呼吸问卷(SGRQ)、匹兹堡睡眠质量指数(PSQI)量表、Epworth嗜睡量表(ESS)及汉密尔顿焦虑量表(HAMA)和抑郁量表(HAMD)评估。【结果】多元逐步线性回归分析结果表明,年龄(标准化系数β=-0.264,P=0.007)、HAMD评分(β=-0.246,P=0.005)、SGRQ活动部分评分(β=-0.194,P=0.029)和股四头肌力量(β=0.197,P=0.030)对COPD患者6 min步行距离(6MWD)有显著预测意义。【结论】年龄、抑郁、日常活动能力和股四头肌力量可能是稳定期COPD患者运动能力的主要影响因素。[Objective] To investigate the important factors for exercise capacity in patients with stable chronic obstructive pulmonary disease （COPD）. [Methods] A total of 109 consecutive subjects with stable COPD underwent a six-minute walk test （6MWT）, while inspiratory capacity （IC） was recorded before and immediately after walking. Spirometry, quadriceps muscle function, the Modified Medical Research Council （mMRC） dyspnea scale, St George＇s Respiratory Questionnaire （SGRQ）, Pittsburgh Sleep Quality Index （PSQI）, Epworth Sleeping Scale （ESS）, Hamihon Anxiety Scale （HAMA） and Hamilton Depression Scale （HAMD） were also assessed. [ Results ] Multiple stepwise regression analysis was performed to identify that the significant predictors of six-minute walk distance （6MWD） were age （standardized coefficient β = -0.264,P = 0.007） , HAMD score （β = -0.246, P = 0.005）, SGRQ activity score （β= -0.194, P = 0.029） and strength in quadriceps muscle （β = 0.197, P = 0.030）. [Conclusion] Age, depression, physical activity in daily life and strength in quadriceps muscle may be the major factors associated with functional exercise capacity in patients with stable COPD.

关 键 词：慢性阻塞性肺疾病 运动能力 HAMD SGRQ 股四头肌 

分 类 号：R563[医药卫生—呼吸系统]