慢性阻塞性肺疾病患者进餐低氧与PFSDQ-M问卷的应用研究

Study of meal-induced hypoxemia in COPD patients and application of the modified version of the pulmonary functional status and dyspnea questionnaire (PFSDQ-M).

目的应用肺功能状态与呼吸困难问卷-修订版(PFSDQ-M)评估慢性阻塞性肺疾病(COPD)患者进餐低氧的变化。方法对2004年11月至2005年10月上海交通大学医学院附属新华医院呼吸科的63例COPD患者进行PFSDQ-M问卷的评分,并对其中49例进行肺功能测定和进餐氧饱和度监测。根据肺功能等级分组,分析脉搏氧饱和度(SpO2)和问卷各区域分值与进餐低氧的相关性。结果不同肺功能状态COPD患者餐后SpO2下降幅度不同(P<0.05)。PFSDQ-M问卷中活动受限、呼吸困难和疲劳程度3个区域得分组间差异有显著性意义(P<0.05),回归分析示PFSDQ-M问卷中呼吸困难区域和疲劳频度子区的得分影响到进餐SpO2的变化。结论COPD患者进餐低氧与日常活动中常发生的呼吸困难和疲劳有关,应用PFSDQ-M问卷评估患者气急和疲劳的主观感受是可行的方法,可为临床观察和评价提供重要依据。

Objective To study PFSDQ-M in evaluating meal-induced hypoxemia in patients with chronic obstructive pulmonary disease. Methods PFSDQ-M scores were collected from 63 COPD patients;49 of them were performed spirometry and meal-related SpO2 monitoring. On the basis of different lung function parameters, data analysis was used to assess the relationship between PFSDQ-M and meal-induced hypoxemia. Results The SpO2 fluctuation during eating period was of significant difference in COPD patients with 3 respective levels of pulmonary function parameters （ P 〈0.05 ）. The sub-regions＇ scores of PFSDQ-M including activity levels, dyspnea and fatigue showed significant difference in 3 groups （ P 〈0. 05 ）. Stepwise regression analysis showed dyspnea sub-region and fatigue-frequency section selected as independent, significant contributors to the variation in SpO2 fluctuation. Conclusion Meal-induced hypoxemia is affected by the relative scales of dyspnea and fatigue in daily activities frequently experienced by COPD patients;thus, PFSDQ-M measurement proves feasible for clinical observation and assessment.