Correlation analysis of CAT score with lung function and blood gas analysis in patients with chronic obstructive pulmonary disease
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摘要:
目的 探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD,以下简称慢阻肺)患者肺功能、血气分析、肺动脉收缩压与慢性阻塞性肺疾病评估测试(COPD assessment test,CAT)评分的关系。 方法 将六安市人民医院呼吸内科2019年9—12月收治的106例COPD患者按照CAT评分法进行疾病状态评定,分为病情轻微组(11例)、中等组(28例)、严重组(41例)、非常严重组(26例),比较不同疾病状态下COPD患者的肺功能,包括第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、一秒率[FEV1/用力肺活量(forced vital capacity,FVC)]、呼气流量峰值(peak expiratory flow,PEF), 血气分析[氧分压(PaO2)、二氧化碳分压(PaCO2)], 肺动脉收缩压(systolic pulmonary artery pressure, sPAP)的差异,探讨各指标与CAT评分的相关性。 结果 CAT评分越低的患者,肺功能各项指标(FEV1、FEV1/FVC、PEF)越高(均P < 0.05);患者CAT评分越低,PaO2越高,PaCO2越低(均P < 0.05),sPAP也越低(P < 0.05);尤其在CAT评分>20分的患者,上述差异尤其明显。Pearson相关分析显示,FEV1、FEV1/FVC、PEF、PaO2与CAT评分呈负相关,PaCO2、sPAP与CAT评分呈正相关。 结论 COPD患者的CAT评分与肺功能、肺动脉收缩压、血气分析指标之间存在相关性,说明CAT评分可以有效预测COPD患者的换气和通气功能障碍,评价患者的肺功能情况。 -
关键词:
- 慢性阻塞性肺疾病 /
- 肺功能 /
- 血气分析 /
- 肺动脉收缩压 /
- 慢性阻塞性肺疾病评估测试
Abstract:Objective To investigate the relationship between pulmonary function, blood gas analysis, pulmonary systolic pressure and CAT score in patients with chronic obstructive pulmonary disease (COPD). Methods Total 106 patients with COPD admitted to the Department of Perspiratory Medicine of Lu'an People's Hospital from September to December 2019 were classified into mild group (11 cases), moderate group (28 cases), severe group (41 cases) and very severe group (26 cases) according to CAT score. The pulmonary function of COPD patients in different disease states, including FEV1, FVC, PEF, PaO2, PaCO2, and sPAP were compared, and the correlation between each index and CAT score was discussed. Results The lower the cat score, the lung function indexes were higher (FEV1, FEV1/FVC, PEF) (all P < 0.05); The lower cat score was, the PaO2 was higher, the PaCO2 was lower (all P < 0.05), and the sPAP was lower (P < 0.05); Especially in patients with cat score >20, the above differences were particularly significant. Pearson correlation analysis shown that FEV1%, FEV1/FVC, PEF% and PaO2 were negatively correlated with CAT score, while PaCO2 and sPAP were positively correlated with CAT score. Conclusion The CAT score of COPD patients was correlated with pulmonary function, pulmonary artery systolic pressure and blood gas analysis. It is proved that CAT score can effectively predict the air exchange dysfunction and ventilation dysfunction of COPD patients, and evaluate the pulmonary function of COPD patients. -
表 1 4组COPD患者各指标比较(x±s)
组别 例数 CAT评分(分) FEV1(%) FEV1/FVC PEF(%) PaO2(mm Hg) PaCO2(mm Hg) sPAP(mm Hg) Ⅰ组 11 8.5±3.4 80.5±5.3 63.4±6.4 71.1±19.5 75.4±7.5 40.4±6.6 22.5±3.9 Ⅱ组 28 16.6±6.6a 56.7±7.6a 53.3±7.3a 52.3±9.8a 68.3±5.5a 43.7±7.8 28.4±4.6ab Ⅲ组 41 23.6±5.8ab 42.6±6.4ab 48.2±9.1ab 38.3±11.5ab 59.3±7.1ab 46.1±6.9a 37.4±4.6ab Ⅳ组 26 31.7±8.3abc 30.4±3.3abc 32.3±5.4abc 29.4±7.4abc 51.6±6.6abc 54.3±5.6abc 39.6±5.7ab F值 35.091 207.840 56.240 43.800 46.753 15.704 51.701 P值 0.012 0.023 0.031 0.015 0.026 0.033 0.041 注:与Ⅰ组比较,aP < 0.05;与Ⅱ组比较,bP < 0.05;与Ⅲ组比较,cP < 0.05。 表 2 COPD患者肺功能、血气分析、肺动脉压与CAT评分的相关性分析
统计量 FEV1(%) FEV1/FVC PEF(%) PaO2(mm Hg) PaCO2(mm Hg) sPAP(mm Hg) r值 -0.470 -0.520 -0.360 -0.490 0.570 0.420 P值 0.034 < 0.001 0.032 0.044 < 0.001 0.033 -
[1] 胡维, 眭建. 社区医院有关慢性阻塞性肺疾病现况的调查[J]. 中华全科医学, 2015, 13(10): 1658-1660. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201510037.htm [2] WIKLUND I, BERRY P, LU K X, et al. The Chinese translation of COPD Assessment TestTM(CAT) provides valid and reliable measurement of COPD health status in Chinese COPD patients[J]. AM J Respir Crit Med, 2010. DOI: 10.1164/ajrccm-conference.2010.181.1_MeetingAbstracts.A3575. [3] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组. 慢性阻塞性肺疾病诊治指南(2013年修订版)[J]. 中华结核和呼吸病杂志, 2018, 36(4): 255-264. https://www.cnki.com.cn/Article/CJFDTOTAL-YXQY201402028.htm [4] SIN D D, WU L L, MAN S F P. The relationship between reduced lung function and cardiovascular mortality: A population-based study and a systematic review of the literature[J]. Chest, 2005, 127(6): 1952-1959. doi: 10.1378/chest.127.6.1952 [5] LABAKI W W, HAN M K. Improving detection of early chronic obstructive pulmonary disease[J]. Ann Am Thorac Soc, 2018, 15(Suppl 4): S243-S248. [6] SCHERMER T R, ROBBERTS B, CROCKETT A J, et al. Should the diagnosis of COPD be based on a single spirometry test?[J]. NPJ Prim Care Respir Med, 2016, 26: 16059. doi: 10.1038/npjpcrm.2016.59 [7] DE MARCO V G, HABIBI J, WHALEY-CONNELL A T, et al. Oxidative stresscontributes to pulmonary hypertension in the transgenic(mRen2)27 rat[J]. Am J Physiol Heart Circ Physiol, 2008, 294(6): 2659-2668. doi: 10.1152/ajpheart.00953.2007 [8] SEEGER W, ADIR Y, BARBERÀ J A, et al. Pulmonary hypertension in chronic lung diseases[J]. J Am Coll Cardiol, 2013, 62(25): D109-116. doi: 10.1016/j.jacc.2013.10.036 [9] ALLINSON J P, HARDY R, DONALDSON G C, et al. The presence of chronic mucus hypersecretion across adult life in relation to chronic obstructive pulmonary disease development[J]. Am J Respir Crit Care Med, 2016, 193(6): 662-672. doi: 10.1164/rccm.201511-2210OC [10] 乔智灏, 刘昶, 张梦雅. 痰热清注射液联合噻托溴铵对尘肺病合并慢性阻塞性肺疾病患者呼吸功能的影响[J]. 中华全科医学, 2019, 17(3): 409-412. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201903020.htm [11] 杨建民, 郑喜文, 陈雪, 等. CAT、mMRC评分在评估COPD患者分组中的差异性研究[J]. 中华全科医学, 2017, 15(7): 1181-1184. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201707028.htm [12] 宋雅君, 周哲慧, 柳耀康, 等. 慢性阻塞性肺疾病稳定期患者肺功能、血气分析指标与CAT评分的相关性分析[J]. 医学临床研究杂志, 2018, 35(2): 312-313. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCF201907005.htm [13] MAKUCH M, MILANOWSKA J, MICHNAR M, et al. The relationship between COPD Assessment Test (CAT) scores and Distress Thermometer (DT) results in COPD patients[J]. Ann Agric Enviro Med, 2020, 27(4): 689-694. doi: 10.26444/aaem/114103 [14] SINGH D, AGUSTI A, ANZUETO A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease: The GOLD science committee report 2019[J]. Eur Respir J, 2019, 53(5): 1900164. doi: 10.1183/13993003.00164-2019 [15] HANSEN H, BIELER T, BEYER N, et al. Supervised pulmonary tele-rehabilitation versus pulmonary rehabilitation in severe COPD: A randomised multicentre trial[J]. Thorax, 2020, 75(5): 413-421. doi: 10.1136/thoraxjnl-2019-214246 [16] YE W, LI X, GU W, et al. A comparison of diagnostic consistency for asthma-chronic obstructive pulmonary disease overlap and clinical characteristics study[J]. BMC Pulm Med, 2019, 19(1): 249-257. doi: 10.1186/s12890-019-1024-2 [17] SIMONNEAAU G, MONTANI D, CELELERMAJER D S, et al. Haemodynamic definitions and updated clinical classification of pulmonary hypertension[J]. Eur Respir J, 2019, 53(1): 1801913. doi: 10.1183/13993003.01913-2018 [18] STOLL P, FOERSTER S, VIRCHOW C J, et al. Overweight is a predictor of long-term survival in hospitalised patients with exacerbations of COPD[J]. Respir Med, 2016, 116: 59-62. doi: 10.1016/j.rmed.2016.05.016 [19] CARONE M, ANTONIUS S, BAIARDI P, et al. Predictors of Mortality in patients with COPD and chronic respiratory failure: The quality-of-life evaluation and survival study (QuESS): A three-year study[J]. COPD, 2015, 13(2): 130-138. http://www.researchgate.net/profile/Giorgio_Bertolotti/publication/283687454_Predictors_of_Mortality_in_Patients_with_COPD_and_Chronic_Respiratory_Failure_The_Quality-of-Life_Evaluation_and_Survival_Study_QuESS_A_Three-Year_Study/links/566e9ebd08ae430ab5002e0e.pdf [20] GARCLA S P, NAVAL E, MARTINEZ R C, et al. The CAT (COPD Assessment Test) questionnaire as a predictor of the evolution of severe COPD exacerbations[J]. Respir MED, 2015, 109(12): 1546-1552. doi: 10.1016/j.rmed.2015.10.011
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