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| 題 名 | Chronic Obstructive Pulmonary Disease Assessment Test (CAT) Correlated Well with Modified Medical Research Council (mMRC) Dyspnea Scale=慢性阻塞性肺病評估問卷(CAT)與修改版醫學研究委員會(mMRC)呼吸困難程度計分有良好相關性 |
|---|---|
| 作 者 | 蔡明儒; 黃脩評; 王程遠; 楊志仁; 許超群; 洪仁宇; 王東衡; 黃明賢; | 書刊名 | 胸腔醫學 |
| 卷 期 | 27:6 2012.12[民101.12] |
| 頁 次 | 頁338-348 |
| 分類號 | 415.428 |
| 關鍵詞 | 慢性阻塞性肺病; 慢性阻塞性肺病評估問卷; 醫學研究委員會呼吸困難程度計分; Chronic obstructive pulmonary disease; Chronic obstructive pulmonary diseaseaAssessment test; Medical research council grade; |
| 語 文 | 英文(English) |
| 中文摘要 | 前言：慢性阻塞性肺疾病是造成失能的主要疾病之一。近來，慢性阻塞性肺病評估問卷（CAT）被推廣在日常診療中用於評估病人的健康狀況。2011年版GOLD指引建議使用CAT及修改版醫學研究委員會呼吸困難程度計分（mMRC）來評估慢性阻塞性肺疾病的症狀。不過，至今鮮有證據顯示這兩個評估工具的結果有良好的相關性。方法：本研究於台灣南部的一家醫學中心胸腔內科門診招募四十歲以上且有抽菸史（大於十包－年）的慢性阻塞性肺疾病病患。在初次收案時及之後每八週回診（三次回診）時，紀錄CAT各項問題之分數及mMRC之分數。計算同次門診之CAT各項分數及總分與mMRC分數的斯皮爾曼氏相關係數。結果：本研究共收錄36名病患，有5名中途退出。分析剩下的31人之資料顯示CAT總分與mMRC分數在初次收案門診時有一個弱相關的趨勢，而於之後的三次追蹤時達到顯著的高度相關（ρ>0.7; p<0.05）。在有較嚴重氣道阻塞（GOLD第3 及第4類）的病人，這相關性會比較好。依據2011年版GOLD指引，在大多數（83%）的狀況下，CAT分數與mMRC分數會將病人分到相同的症狀等級中。結論：雖然這個研究的樣本數很少，不過仍然顯現CAT總分與mMRC分數有很好的相關性，尤其在有較嚴重氣道阻塞的病人以及用在追蹤的時候。因此，在台灣地區繁忙的門診作業中可以使用mMRC這種簡單的量表來取代CAT。這項試驗性的研究可以提供在台灣地區依照2011年版GOLD指引於臨床上使用CAT及mMRC的初步證據支持。期待有更進一步的研究來探討在台灣地區使用CAT於臨床照護的相關議題。 |
| 英文摘要 | Background: Chronic obstructive pulmonary disease (COPD) is among the leading causes of disability. The COPD Assessment Test (CAT) has been advocated recently as a good health status measurement tool for COPD patients in daily practice. Both the CAT and the Modified Medical Research Council (mMRC) Dyspnea Scale were recommended for the assessment of COPD symptoms in the 2011 Global Initiative for Chronic Obstructive Lung Disease (GOLD) report. However, little evidence to date has shown a correlation between these 2 measurements.Methods: Patients more than 40 years of age, with a diagnosis of COPD and a smoking history of more than 10 pack years were prospectively enrolled from the chest clinic of a medical center in Taiwan. The CAT score and mMRC grades were recorded on the first visit and then every 8 weeks for 6 months. Spearman's correlation coefficients (ρ) between the CAT scores and mMRC grades recorded on the same visit were calculated.Results: In total, 36 patients with COPD were enrolled in this study. Five patients were excluded due to early withdrawal, and the data of the remaining 31 patients were analyzed. The CAT score trended toward a weak correlation with the mMRC grade on the first visit, but was highly correlated with the mMRC grade on the next 3 visits (weeks 8, 16, and 24) (ρ>0.7; p<0.05). The correlation was better in patients with a more severe airflow limitation (GOLD class 3 and 4). In most cases (83%), the CAT score and mMRC grade indicated the same level of symptoms, as defined in the 2011 GOLD report.Conclusions: Although the small sample size may have impacted the results, we found that the CAT score had a good correlation with the mMRC grade, especially in patients with a more severe airflow limitation and on follow-up visits. Therefore, as a simple tool, the mMRC scale may be used as a substitute for the CAT in busy clinics in Taiwan. This pilot study may provide preliminary evidence to support the clinical application of the CAT or mMRC scale per the 2011 GOLD report in Taiwan. Further studies are needed to clarify the application of the CAT in a clinical setting in Taiwan. |
本系統中英文摘要資訊取自各篇刊載內容。