慢性阻塞性肺疾病不同表型患者CAT评分与肺功能及预后的相关性分析  

Correlation between CAT Score and Lung Function and Prognosis of Patients with Different Phenotypes of COPD

作　　者：李德经 周晓燕 张楠 凌琳 孙佳 LI De-jing;ZHOU Xiao-yan;ZHANG Nan;LING Lin;SUN Jia(The Affiliated Wuxi People's Hospital of Nanjing Medical University,Wuxi,Jiangsu,214023,China)

机构地区：[1]南京医科大学附属无锡人民医院呼吸与危重症医学科,江苏无锡214023

出　　处：《现代生物医学进展》2024年第4期772-777,共6页Progress in Modern Biomedicine

基　　金：无锡市卫健委面上项目(M202032)。

摘　　要：目的:探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)不同表型评估测试问卷(COPD assessment test,CAT)评分与肺功能及预后的关系。方法:收集361例COPD患者临床资料、CAT评分、肺功能检查结果及肺外合并症、肺内并发症等情况,按临床表型分为肺气肿组(n=200)和支气管炎组(n=161),分析肺气肿组200例和支气管炎组161例COPD患者CAT评分与肺功能及预后的关系。结果:肺气肿组CAT评分高于支气管炎组(P<0.05),一秒用力呼气容积(FEV_(1))占预计值百分比(FEV_(1)%)、FEV_(1)/用力肺活量(FVC)低于支气管炎组(P<0.05),吸气分数(IC/TLC)低于支气管炎组,残总比(RV/TLC)高于支气管炎组(P<0.05);肺气肿组肺间质性病变、肺动脉高压发生率均高于支气管炎组(P<0.05);支气管炎、肺气肿组CAT评分均与FEV_(1)%、FEV_(1)/FVC、IC/TLC呈负相关(P<0.05),与RV/TLC呈正相关(P<0.05),肺气肿各参数相关度更高(P<0.05);肺气肿组不同CAT评分患者肺间质性病变、肺动脉高压发生率比较差异有统计学意义(P<0.05),支气管炎组不同CAT评分肺动脉高压发生率比较差异有统计学意义(P<0.05),随CAT评分的升高,肺气肿组肺间质性病变、肺动脉高压发生率上升,支气管炎组肺动脉高压发生率上升。结论:COPD肺气肿表型CAT评分较支气管炎表型高,肺功能降低更明显,呈现肺过度通气,气流受限特点,更易并发肺间质纤维化、肺动脉高压,且与CAT评分变化密切相关。Objective:To investigate the correlation between COPD assessment test(CAT)scores and lung function as well as prognosis of patients of chronic obstructive pulmonary disease(COPD)with different phenotypes.Methods:A total of 361 patients with COPD were involved in this study.Their clinical data,CAT scores,lung function test results,extrapulmonary comorbidities and intrapulmonary complications were collected.Then,these patients were divided into emphysema group(n=200)and the bronchitis group(n=161)according to their clinical phenotype.The correlation was analyzed between CAT scores,lung function,and prognosis in emphysema group and bronchitis group.Results:The CAT score of the emphysema group was higher than that of the bronchitis group(P<0.05).The percentage of forced expiratory volume in one second(FEV_(1))of the expected value(FEV_(1)%)and FEV_(1)/forced vital capacity(FVC)were lower than those in the bronchitis group(P<0.05).The inspiratory capacity/total lung capacity(IC/TLC)was lower than that of the bronchitis group,and the residual volume/total lung capacity(RV/TLC)was higher than that of the bronchitis group(P<0.05).The incidence rates of pulmonary interstitial disease and pulmonary hypertension in the emphysema group were higher than those in the bronchitis group(P<0.05).The CAT scores of both groups were negatively correlated with FEV_(1)%,FEV_(1)/FVC and IC/TLC(P<0.05),and positively correlated with RV/TLC(P<0.05).The correlation of emphysema parameters was higher(P<0.05).There were statistically significant differences in the incidence rates of pulmonary interstitial disease and pulmonary hypertension between patients with different CAT scores in emphysema group(P<0.05).There was a statistically significant difference in the incidence of pulmonary hypertension between patients with different CAT scores in the bronchitis group(P<0.05).As the CAT score increased,the incidence rates of pulmonary interstitial disease and pulmonary hypertension in the emphysema group increased,and the incidence rate of pulmo

关 键 词：慢性阻塞性肺疾病 慢性阻塞性肺疾病评估测试问卷 肺功能 预后 

分 类 号：R563[医药卫生—呼吸系统]