FEV1预计值与BODE指数在COPD临床评价中的价值

摘要

Objective To compare the value of BODE index and the forced expiratory volume in one second/predicted value ratio(FEVl%pred)in the clinical evaluation of patients with chronic obstructive pulmonary disease(COPD). Methods Eighty-nine patients diagnosed as COPD admitted to Wuhan Central Hospital from March 2010 to March 2011 were included in the study,whose height and weightCbody mass index),lung function,modified Medical Research Council(MMRC)and exercise tolerance were collected. The relationships between the FEV1% pred, BODE index and the smoking index, Six-Minute Walk Test (6MWT) , the times of hospitalization caused by acute exacerbations of chronic obstructive and pulmonary disease(AECOPD) were analyzed respectively. And the ralationships of FEV1% pred, BODE index and 6MWT,and the times of hospitalization caused by AECOPD were analyzed in the urban and rural patients with COPD. Results Smoking index had no correlations with FEV1% pred and the BODE index (P> 0. 05) . A significant positive correlation was found between the FEVl%pred and 6MWT(r=0. 593 3,P<0. 01), as well as between BODE index and the times of hospitalization caused by AECOPD (r = 0.514 2,P<0. 01). A significant negative correlation was found between the FEVl%pred and the times of hospitalization caused by AECOPD(r= -0. 325 2,P<0. 01),as well as between BODE index and 6MWT(r= -0. 777 5,P<0. 01). The FEVl%pred exhibited significant difference between the patients in cities and those in countries with moderate/severe COPD. Respectively,BODE index showed no difference. Conclusion FEVl%pred and BODE index can evaluate the severity of COPD patients,and BODE index is more accurate.%目的 比较BODE指数及第1秒用力呼气容积占预计值百分比(FEV1%预计值)在慢性阻塞性肺疾病(COPD)患者临床评价中的作用.方法 对2010年3月至2011年3月在武汉市中心医院呼吸内科就诊的89例COPD患者的身高、体重(计算体重指数),肺功能指标,呼吸困难程度(MMRC)和运动耐力进行测定.分析FEV1%预计值和BODE指数分别与吸烟指数、6 min步行实验及COPD急性加重(AECOPD)住院次数之间的关系;并分析农村和城市COPD患者FEV1%预计值和BODE指数分别与6 min步行实验和COPD急性加重住院次数的关系.结果 吸烟指数与FEV1%预计值和BODE指数均无相关性(P＞0.05).FEV1%预计值与6 min步行实验呈正相关(r=0.593 3,P＜0.01);FEV1%预计值与COPD急性加重住院次数呈负相关(r=-0.325 2,P＜0.01).BODE指数与6 min步行实验呈明显的负相关(r=-0.777 5,P＜0.01);BODE指数与COPD急性加重住院次数呈正相关(r=0.514 2,P＜0.01).在COPD分级中度的患者中,FEV1%预计值在城市和农村患者之间有显著性差异,而BODE指数在城市和农村患者之间无显著性差异.在COPD分级重度的患者中亦得出相同的结果.结论 FEV1%预计值和BODE指数均能够评价COPD患者的病情严重程度,但以BODE指数的判断更为全面及准确.