CAT评分在慢性阻塞性肺疾病中的临床应用

Clinical application of CAT scale in chronic obstructive pulmonary disease

目的评估慢性阻塞性肺病评估测试(COPD Assessment Test,CAT)量表与肺功能、呼吸困难评分的关系,探讨CAT评分对识别慢阻肺患者的临床价值。方法对157例患者进行肺功能检查,利用CAT量表、改良英国医学研究委员会呼吸困难评级(Modified Medical Research Council Dyspnea,MMRC)量表进行评分。SPSS 16.0和Graph Pad Prism 5.0对结果进行统计分析。结果例患者中,慢阻肺患者80例,非慢阻肺患者77例。两组的CAT评分差异有统计学意义(P<0.001)。慢阻肺患者的CAT评分和MMRC评级均随着慢性阻塞性肺疾病全球倡议(Global initiative for chronic Obstructive Lung Disease,GOLD)分级增加而增加,慢阻肺组CAT评分与肺功能呈负相关(r=-0.47,P<0.001),和MMRC成正相关(rs=0.68,P<0.001)。CAT评分识别慢阻肺的敏感度78.75%,特异度94.81%,ROC曲线下面积0.93。结论 CAT评分与慢阻肺患者肺功能和MMRC评分均有相关性,对慢阻肺有潜在的诊断价值,可用于慢阻肺患者的筛查与评估。

Objective To explore the relationship of CAT with lung function and dyspnea scale and to evaluate the application of CAT scale in chronic obstructive pulmonary disease. Methods The lung function of 157 patients were tested by CAT scores and MMRC scores. Statistic analysis was conducted using SPSS 16. 0 and GraphPad Prism 5. 0. Results 157 patients included 80 cases of COPD and 77 non-COPD cases. CAT scores differed significantly between patients with or without COPD （P〈0. 001）. The scores of CAT and MMRC increased in COPD patients with the increasing classification of Global initiative for chronic Obstructive Lung Disease （ GOLD） . The scores of CAT in COPD patients were negatively correlated with pulmonary function （r= -0. 47, P〈0. 001）, and positively correlated with MMRC scores （rs =0. 68, P〈0. 001）. The sensitivity and specificity of CAT scores in the diagnosis of COPD were 78. 75% and 94. 81%. Area under the curve was 0. 93. Conclusion CAT scores are correlated with MMRC scores and pulmonary function in COPD patients. CAT has potential values in screening COPD and can be applied in identification and assessment of COPD patients.