肺功能状态和呼吸困难问卷用于慢性阻塞性肺疾病患者的信度与效度研究

Reliability and validity of modified pulmonary functional status and dyspnea questionnaire in Chinese patients with chronic obstructive pulmonary disease

目的评价中文版肺功能状态和呼吸困难问卷（PFSDQ）修订版用于COPD患者的信度和效度。方法于2009年4—9月在北京市2家医院呼吸科门诊选取COPD稳定期患者61例，其中男52例，女9例；年龄51～80岁，平均（66±7）岁。用PFSDQ修订版和修订的英国医学委员会呼吸困难量表（MMRC量表）评估其呼吸困难及功能情况，并于同日或1周内进行检测肺功能和6min步行试验。PFSDQ修订版包括活动受限程度、活动后呼吸困难和活动后疲乏3个维度。结果PFSDQ修订版中活动受限、活动后呼吸困难和活动后疲乏3个维度的克龙巴赫仪系数分别为0．84、0．85和0．89，与6min步行距离、FEVl、FEV。／FVC、FEV．占预计值％、MMRC测评的呼吸困难程度和BODE指数均有显著相关性（，值为-0．27～0．66，均P〈0．01）。上述3个维度在病情严重程度不同的患者中进行两两比较，差异均有统计学意义（）f。值为7．35～15．21，P〈0．05和P〈0．01）。结论中文版PFSDQ修订版在61例COPD患者中使用具有良好的信度和效度，适用于我国COPD患者。

Objective To determine the reliability and validity of the modified pulmonary functional status and dyspnea questionnaire （PFSDQ-M） Chinese version in patients with chronic obstructive pulmonary disease （COPD） at 2 hospitals in Beijing, China. Methods PFSDQ-M has three domains, i.e. , change experienced by patient with activities or activity restriction （ CA）, dyspnea with activities （DA） and fatigue with activities （ FA ）. Sixty-one patients with COPD in stable condition were assessed by interview with PFSDQ-M Chinese version, modified Medical Research Council dyspnea scale （MMRC）, respectively, and underwent pulmonary function test （PFT） and 6-minute walking test （6MWT） on the same day or within one week before interview. Results Cronbach＇ s alpha was 0. 84, 0. 85 and O. 89 for domains of CA, DA and FA of the PFSDQ-M, respectively. Scores of change in activities, dyspnea and fatigue with activities in patients of COPD correlated to their 6-minute walking distance （ r = - 0. 39 to - 0. 50）, FEV1（ r = - O. 28 to -0. 36）, FEV1/FVC （r = -0.27 to -0. 37）, FEV1% of predicted （r = -0.27 to -0.37）, dyspnea score in MMRC （ r = 0. 59 to 0. 66） and BODE index （ r = 0. 40 to 0. 51 ）, respectively （ all P 〈 0. 01 ）. Degrees of restriction of activity, dyspnea and fatigue with activities varied significantly in patients with different severity of COPD （ X2 = 7.35 to 15.21, P 〈 O. 05, P 〈 0. 01, respectively）. Conclusions Results of 61 patients with COPD interviewed with PFSDQ-M Chinese version suggest its good reliability and validity in discriminating patients with COPD of varied severity and stages.