慢性阻塞性肺疾病的晨间症状及其评估方法

Evaluation of morning symptoms of chronic obstructive pulmonary disease

传统观点认为,哮喘是一种变异性较大的疾病,其症状会发生昼夜节律的变化,而认为慢性阻塞性肺疾病(简称慢阻肺)患者在稳定期其症状变化不大。然而越来越多的研究表明,慢阻肺患者的症状也存在日间变异性,以晨间症状最多见,并且晨间症状与患者更差的健康状况和生活质量、日常活动能力的下降及急性加重风险均密切相关。近些年国外已有学者开发了一些用于定量评估慢阻肺患者晨间症状的测评量表,如PRO-慢阻肺晨间症状问卷、EMSCI量表、CDLM和GCSQ问卷、MEMSI指数以及COPD-MSD量表等。在临床实际工作中,应更加关注、重视患者的晨间症状并应用现有量表进行评估。

According to the traditional view,asthma is a disease with great variability,and its symptoms will change with the circadian rhythm,while it is believed that patients with chronic obstructive pulmonary disease(COPD)will have little change in their symptoms during the stable period.However,a growing number of studies have shown that patients with COPD also have diurnal variability in their symptoms,most commonly morning symptoms,and that morning symptoms are closely related to patients’worse health and quality of life,decreased ability to perform daily activities,and acute exacerbation risk.In recent years,foreign scholars have also developed some measurement scales for quantitative evaluation of morning symptoms of COPD patients,such as Patient Reported Outcomes(PRO)-Morning COPD Symptoms Questionnaire,Early Morning Symptoms of COPD Instruments,Capacity of Daily Living during the Morning questionnaire,Manchester Early Morning Symptoms Index and Chronic Obstructive Pulmonary Disease Morning Symptom Diary.In clinical practice,we should pay more attention to patients’morning symptoms and evaluate them with existing scales.