摘要
目的慢性阻塞性肺疾病(COPD)是一种异质性很强的疾病。由于存在相同的生物学或生理学机制,理论上可以将具有相同临床表现、治疗反应及预后的患者归类即可称为一类表型。目前对各种临床表型的研究尚不够深入,使COPD的诊断、评估及治疗面临困境。将根据COPD患者的体重指数(BMI)、肺气肿评分(Goddard评分)、呼出气一氧化氮(FeNO)值进行特征研究,以提高对COPD的认识。方法选取2011年5月至2012年2月在上海交通大学医学院附属瑞金医院呼吸科就诊的稳定期COPD患者,进行相关临床数据的采集,包括肺功能检查、病史询问、COPD评估测验(CAT)、圣.乔治呼吸问题调查(SGRQ)、医院焦虑抑郁评分(HAD)、FeNO、6分钟步行距离试验等。根据BMI、Goddard评分、FeNO值分类进行特征研究。结果符合入选条件的稳定期COPD患者共126例。BMI 1级患者生活质量较差,HAD较高,FEV1较低,弥散功能较差,肺气肿评分较高。BMI 4级患者静息氧饱和度较低。不能通过FeNO将患者进行表型分类。肺气肿型患者BMI较低,弥散功能下降,生活质量更差。结论可以通过BMI及Goddard评分区分出一组具有相同特征的COPD型,即低BMI型及肺气肿型,但不能通过FeNO来分型。
Objective Chronic obstructive pulmonary disease （COPD） is highly heterogeneous. In theory, the patients with same clinical manifestations, treatment response and prognosis can be classified into one phenotype, which may have same biological or physiological mechanisms. In this study the profiles of patients with COPD including body mass index（ BMI）, Goddard score, fractional exhaled nitric oxide （FeNO） were analyzed in order to find some special phenotypes. Methods Patients with COPD at stable stage in Ruijin Hospital from May 2011 to February 2012 were evaluated with COPD assessment test（CAT） in Chinese version, St. George＇ s Respiratory Questionnaire （ SGRQ）, hospital anxiety and depression （HAD） rating scale, pulmonary function test, and 6-minute walking test （6MWT）. Baseline data was collected including height, weight, drug use, times of exacerbation, etc. Results A total of 126 patients were recruited. The patients with low BMI had poorer quality of life, lower FEV1 , poorer diffusion function, and higher Goddard score, and was easier to develop anxiety and depression. The patients with high BMI had lower oxygen saturation at rest. We failed to define a certain kind of phenotype according to FeNO. The patients of emphysema phenotype（assessed by Goddard score） had lower BMI, decreased lung diffusion capacity, and poorer quality of life. Conclusion The study can define COPD patients into some special phenotypes （ low BMI and emphysema phenotype） ,but failed to define a certain kind of phenotype according to FeNO.
出处
《中国呼吸与危重监护杂志》
CAS
2013年第3期223-227,共5页
Chinese Journal of Respiratory and Critical Care Medicine
关键词
慢性阻塞性肺疾病
表型
体重指数
呼出气一氧化氮
肺气肿评分
Chronic obstructive pulmonary disease
Phenotype
Body mass index
Fractional exhaled nitric oxide
Goddard score
