BODE评分系统对慢性阻塞性肺疾病临床预后价值的研究

Application of BODE grading system in evaluating clinical prognosis of chronic obstructive pulmonary disease

目的评价BODE评分（由体重指数、气流阻塞程度、呼吸困难和运动耐力4部分组成）对慢性阻塞性肺疾病患者的应用价值。方法选择2003年9月至2007年12月间在宣武医院就诊的稳定期慢性阻塞性肺疾病患者40例，男25例，女15例，年龄38～85岁，平均年龄（62±13）岁。于入选第1年结束时、第3年结束时分别采集患者的BODE评分；同时记录两年间慢性阻塞性肺疾病患者急性发作次数、急性发作持续时间、住院时间、住院次数，所有参数应用SPSS13．0进行统计学分析。结果评分≥5分组与〈5分组患者病情严重程度的指标间差异有统计学意义（P〈0．01）；BODE评分与第一秒用力呼气容积呈显著负相关（≥5分组P〈0．01，〈5分组P〈0．05）；BODE评分与急性发作次数、急性发作持续时间、住院时间、住院次数呈显著正相关（≥5分组P〈0．01，〈5分组P〈0．05）；第1年与第3年慢性阻塞性肺疾病患者的BODE评分呈显著正相关（r=0．834，P〈0．01）。结论BODE指数是评价慢性阻塞性肺疾病患者病情严重程度的良好指标。

Objective The aim of this study is to evaluate clinical application of BODE （ body mass index, airflow obstruction, dyspnea, and exercise capacity ） index in patients with chronic obstructive pulmonary disease （COPD）. Methods Forty patients with stable COPD in Xuanwu Hospital of Beijing during September 2003 to December 2007, were recruited in the study, including 25 men and 15 women, aged 38 to 85 years （with a mean of 62 ± 13 years）. BODE index was measured for each patient, one year and three years after recruitment, respectively. Severity of COPD, including number and duration of episodes, length of each hospital stay and times of hospitalization due to acute exacerbation of COPD （ AECOPD ） , were recorded. All data were statistically analyzed with SPSS 13.0 software for windows. Results （1）There was a remarkable difference in COPD severity between patients with BODE score equal to or greater than five and those with less than five （P 〈 0. 01 ）. （2）BODE score inversely correlated with forced expired volume at the first second （FEV1 ） in COPD patients （P 〈0. 01 for those with BODE score equal to or greater than five and P 〈 0. 05 for those with BODE score less than five, respectively）. （3）BODE score positively correlated with number and duration of acute exacerbation, length of hospital stay and times of hospitalization due to AECOPD （P 〈 0. 01 for those with BODE score equal to or greater than five and P 〈 0. 05 for those with BODE score less than five, respectively）. For patients with COPD, their BODE score in the first year positively correlated with that in the third year （ r = 0. 834, P 〈 0. 01 ）. Conclusions BODE index is a better indicator to evaluate their condition severity in patients with COPD.