圣乔治呼吸问卷、CAT及mMRC评分在慢性阻塞性肺病中的应用  

Application of St George’s respiratory questionnaire,CAT and mMRC in chronic obstructive pulmonary disease

作　　者：孟现玲 何玉廷 毛若琳 陈智鸿 MENG Xian-ling;HE Yu-ting;MAO Ruo-lin;CHEN Zhi-hong(Department of Pulmonary and Critical Care Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Pulmonary and Critical Care Medicine,Funan County People’s Hospital of Anhui Province,Funan 236300,Anhui Province,China)

机构地区：[1]复旦大学附属中山医院呼吸科与危重医学科,上海200032 [2]安徽省阜南县人民医院呼吸与危重医学科,阜南236300

出　　处：《复旦学报（医学版）》2022年第6期862-868,876,共8页Fudan University Journal of Medical Sciences

基　　金：国家自然科学基金(81970023);上海市卫健委课题(201840288);上海市重中之重临床建设项目(2017ZZ02013)。

摘　　要：目的探讨3种呼吸问卷评分之间的相关性及其与肺通气功能严重程度的相关性,了解现有的呼吸问卷用于评估慢性阻塞性肺病(chronic obstructive pulmonary disease,COPD)病情和肺通气功能受损程度的优劣。方法纳入复旦大学附属中山医院2019年4月7日—2020年4月11日的109例稳定期COPD患者。记录患者一般情况、临床症状、并发症、受教育程度、呼吸问卷(CAT、mMRC、SGRQ)评分、肺功能参数、治疗用药等,分析各指标与3种呼吸问卷评分的相关性。结果109例患者中,轻-中度COPD患者(FEV1%pred≥50%)62例(56.88%),重-极重度COPD患者(FEV1%pred<50%)47例(43.12%)。相关性分析显示,SGRQ、mMRC、CAT评分之间均具有良好的相关性(P<0.05);分层分析发现,对重-极重度患者,SGRQ(总分和症状部分)、mMRC、CAT评分能较好反映其肺功能(FEV1%pred)水平(r:0.4~0.5),而对轻-中度COPD患者,上述评分与患者的肺通气功能之间无明显相关性。结论3种呼吸问卷两两之间相关性好,均可用于COPD评价。SGRQ评分全面系统,在呼吸疾病科学研究中具有重要价值;CAT评分侧重临床使用,方便快捷;SGRQ评分及CAT评分与重-极重度肺通气功能受损程度具有良好的相关性。Objective To explore the correlation between the scores of the three respiratory questionnaires and its correlation with the severity of pulmonary ventilation function,and evaluate the role of three existing respiratory questionnaires when assessing the severity of chronic obstructive pulmonary disease and lung ventilation function impairment.Methods A total of 109 patients with stable chronic obstructive pulmonary disease were enrolled in Zhongshan Hospital,Fudan University from Apr 7,2019 to Apr 11,2020.The demographic situation,clinical symptoms,complications,education level,respiratory questionnaire scores(CAT,mMRC and SGRQ score),lung function parameters,therapeutic drugs were recorded,and the correlation between each index and the 3 respiratory questionnaire scores was analyzed.Results Among 109 patients,62 patients(56.88%)had mild to moderate COPD(FEV1%pred≥50%)and 47 patients(43.12%)had severe to very severe COPD(FEV1%pred<50%).The correlation analysis showed that there was a good correlation among SGRQ,mMRC and CAT scores(P<0.05).Stratified analysis showed that SGRQ(total score and symptom part score),mMRC and CAT scores could better reflect the level of pulmonary function(FEV1%PRED)(r:0.4-0.5)in patients with severe to very severe COPD,while there was no significant correlation in patients with mild to moderate chronic obstructive pulmonary disease.Conclusion The 3 kinds of respiratory questionnaires have good correlation and can be used to evaluate COPD.SGRQ score is of great value in scientific research of respiratory diseases.CAT score is more focused on clinical use,which is convenient and fast.The SGRQ score and CAT score were well correlated with the severe to very severe pulmonary ventilation function impairment.

关 键 词：慢性阻塞性肺病(COPD) 肺通气功能 SGRQ评分 CAT评分 mMRC评分 

分 类 号：R563[医药卫生—呼吸系统]