识别慢性阻塞性肺病患者的异常用力呼吸困难：比较 mMRC 和 CAT 与 CPET。

IF 9.5 1区医学 Q1 CRITICAL CARE MEDICINE Chest Pub Date : 2024-10-25 DOI:10.1016/j.chest.2024.10.027

Magnus Ekström, Hayley Lewthwaite, Pei Zhi Li, Jean Bourbeau, Wan C Tan, Dennis Jensen

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引用次数: 0

摘要

背景：慢性阻塞性肺疾病（COPD）的治疗以呼吸道症状负担为指导，使用改良医学研究委员会（mMRC）量表和/或慢性阻塞性肺疾病评估测试（CAT）进行评估：研究设计与方法：使用常模参考方程分析年龄≥40 岁、在 CPET 症状限制峰值时支气管扩张剂后 FEV1/FVC 正常值上限 (ULN) 的患者：我们纳入了 318 名慢性阻塞性肺病患者（40% 为女性），年龄为 66.5±9.3 岁（平均值±SD），预测 FEV1 为 79.5±19.0%；26% 的患者运动能力异常低（V'O2peak 解释：在慢性阻塞性肺病患者中，mMRC 和 CAT 与 CPET 的一致性较低，无法识别出许多存在异常高的劳累性呼吸困难的患者。

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Identifying abnormal exertional breathlessness in COPD: comparing mMRC and CAT with CPET.

Background: Chronic obstructive pulmonary disease (COPD) management is guided by the respiratory symptom burden, assessed using the modified Medical Research Council (mMRC) scale and/or COPD Assessment Test (CAT).

Research question: What is the ability of mMRC and CAT to detect abnormally high exertional breathlessness on incremental cardiopulmonary cycle exercise testing (CPET) in people with COPD?

Study design and methods: Analysis of people aged ≥40 years with post-bronchodilator FEV₁/FVC<0.70 and ≥10 smoking pack-years from the Canadian Cohort Obstructive Lung Disease study. Abnormal exertional breathlessness was defined as a breathlessness (Borg 0-10) intensity rating > upper limit of normal (ULN) at the symptom-limited peak of CPET using normative reference equations.

Results: We included 318 people with COPD (40% women), age 66.5±9.3 years (mean±SD), FEV₁ 79.5±19.0%predicted; 26% had abnormally low exercise capacity (V'O_2peak

Interpretation: In COPD, mMRC and CAT have low concordance with CPET and fail to identify many people with abnormally high exertional breathlessness.

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来源期刊

Chest 医学-呼吸系统

CiteScore

13.70

自引率

3.10%

发文量

3369

审稿时长

15 days

期刊介绍： At CHEST, our mission is to revolutionize patient care through the collaboration of multidisciplinary clinicians in the fields of pulmonary, critical care, and sleep medicine. We achieve this by publishing cutting-edge clinical research that addresses current challenges and brings forth future advancements. To enhance understanding in a rapidly evolving field, CHEST also features review articles, commentaries, and facilitates discussions on emerging controversies. We place great emphasis on scientific rigor, employing a rigorous peer review process, and ensuring all accepted content is published online within two weeks.