慢性阻塞性肺疾病评估测试中文版临床应用意义的评价

Evaluation of clinical signifficance of chronic obstructive pulmonary disease assessment test

目的 研究COPD评估测试（CAT）中文版用于评估我国COPD患者生命质量的信度和效度,观察其用于评估生命质量的作用和价值.方法 选择北京协和医院COPD稳定期患者,应用CAT中文版评估患者的生命质量,同时测定肺功能,对结果进行相关性分析,评价CAT内部一致性的信度和效度.根据CAT评分对患者进行分级,并与根据肺功能的分级进行比较,观察其对病情严重程度的评估价值.结果 135例COPD患者中,男105例,女30例,年龄45～84岁,平均（65±10）岁.CAT评分随患者病情加重而逐渐增加,CAT量表的总克龙巴赫α系数为0.805,CAT总分与FEV1占预计值%呈显著负相关（r值为-0.567,P＜0.01）.病情严重程度不同的4组COPD患者,其CAT总分分别为（10±5）分、（16±6）分、（21±7）分和（23±6）分,组间比较的差异有统计学意义（x2值为48.437,P＜0.01）.根据CAT分级和根据肺功能COPD严重程度分级比较,两者具有高度一致性.结论 CAT中文版用于我国COPD患者,具有良好的内部一致性信度和效度,可用于患者生命质量的评估,是一种简易、可靠、有效的标准化测量方法.

Objective To determine the reliability and validity of the COPD assessment test （CAT）Chinese version in patients with chronic obstructive pulmonary disease （ COPD ）, and to study its value in evaluating quality of life in Chinese patients.Methods One hundred and thirty-five patients with COPD in stable condition from Peking Union Medical College Hospital were assessed by interview with CAT Chinese version,and underwent pulmonary function test on the same day.The validity was documented by performing correlation analysis, and Pearson＇ s correlation coefficients were calculated.The stages of COPD determined by CAT score and lung function were compared to observe the value of CAT in determining disease severity.Results Cronbach＇ s alpha of CAT Chinese version was 0.805.CAT score increased with the severity of the disease, and was negatively correlated to FEV1 % of predicted （ r = - 0.567, P 〈 0.01 ）.CAT score varied significantly in patients （ 10 ± 5, 16 ± 6, 21 ± 7 and 23 ± 6 ）, with different severity of COPD （ x2 =48.437, P 〈0.01 ）.There was a high degree of consistency between the stages of COPD determined by CAT score and lung function.Conclusions The Chinese version of the CAT had good internal consistency reliability and validity, and can be used to assess the quality of life for Chinese COPD patients.It provided a simple, valid and standardized measurement of COPD health status.