摘要
目的探讨慢性阻塞性肺疾病评估测试(chronic obstructive pulmonary disease assessment test,CAT)问卷对不同年龄稳定期慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者病情评估效能的差异,为CAT问卷对不同年龄COPD患者进行诊前筛查、病情评估提供依据。方法选取2020年9—12月清华大学附属北京清华长庚医院呼吸与危重症医学科门诊就诊的稳定期COPD患者128例,收集其基本信息、CAT问卷评分和肺功能检查结果,以年龄65岁为界值分为两组,<65岁为中青年组,≥65岁为老年组。比较两组CAT问卷评分与肺功能慢性阻塞性肺病全球倡议(Global Initiative for Chronic Obstructive Lung Disease,GOLD)分级的关系,与第1秒用力呼气容积(forced expiratory volume in 1 second,FEV1)的相关性分析,并绘制CAT问卷评分对重度及以上COPD诊断的ROC曲线。结果随着肺功能GOLD分级的增加,老年组CAT评分逐渐升高[Ⅰ级(4.83±3.42)分,Ⅱ级(9.26±6.73)分,Ⅲ级(14.33±7.51)分,Ⅳ级(19.20±5.03)分],组间两两比较,差异均有统计学意义(P<0.05)。中青年组和老年组CAT问卷评分均与FEV1呈负相关(r=-0.369、-0.544,P均<0.05),但老年组相关系数绝对值大于中青年组,散点图更密集。CAT评分取12.5分为界值时,约登指数最大,灵敏度为58.1%,特异性为90.6%。结论老年COPD患者CAT问卷评分与肺功能的严重程度较中青年一致性更高。CAT问卷对老年患者病情评估的精确性更好,诊断效能更高,优于中青年。CAT评分取值12.5分可大致分出轻中度与重度、极重度COPD患者。
Objective To explore the efficacy of chronic obstructive pulmonary disease assessment test(CAT questionnaire in evaluating the condition of patients with stable chronic obstructive pulmonary disease(COPD)in different age group so as to provide a basis for CAT questionnaire to screen and evaluate the condition of COPD patients in different ages.Methods Basic information,CAT questionnaire score and pulmonary function examination results of 128 patients with stable COPD in the Outpatient Department of Respiratory and Critical Care Medicine of Beijing Tsinghua Changgung Hospital affiliated to Tsinghua University from September to December 2020 were collected.They were divided into young and middle-aged group(less than 65 years old)and elderly group(equal to or greater than 65 years old).The relationship between the CAT questionnaire scores and the Global Initiative for Chronic Obstructive Lung Disease(GOLD)grading were compared,and the correlation between the CAT questionnaire scores and forced expiratory volume in 1 second(FEV1)of the two groups were analyzed,and the ROC of CAT questionnaire scores for the diagnosis of severe and extremely severe COPD was drawn.Results With the increased GOLD pulmonary function grading,the CAT score in the elderly group gradually increased[Ⅰ(4.83±3.42)points,Ⅱ(9.26±6.73)points,Ⅲ(14.33±7.51)points,Ⅳ(19.20±5.03)points],and the difference between any two groups was statistically significant(P<0.05).The CAT questionnaire score of the young and middle-aged group and the elderly group were both negatively correlated with FEV1(r=-0.369,-0.544,P<0.05),but the absolute value of the correlation coefficient of the elderly group was greater than that of the young and middle-aged group,and the scatter plot was more dense.When the CAT score was 12.5 points as the boundary value,the youden index was the largest,with a sensitivity of 58.1%and a specificity of 90.6%.Conclusions The consistency between the CAT questionnaire score and the severity of pulmonary function in elderly patients with COPD is higher than that in young and middle-aged patients.CAT questionnaire has better accuracy and diagnostic efficiency in the evaluation of the condition of elderly patients,which is better than that of young and middle-aged patients.CAT score of 12.5 points can roughly distinguish mild to moderate from severe and extremely severe COPD patients.
作者
高博
郭军
李娜
牟向东
Gao Bo;Guo Jun;Li Na;Mou Xiangdong(Department of Respiratory and Critical Care Medicine,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China)
出处
《北京医学》
CAS
2022年第6期485-489,共5页
Beijing Medical Journal
关键词
慢性阻塞性肺疾病评估测试问卷
慢性阻塞性肺疾病
年龄
病情评估
chronic obstructive pulmonary disease assessment test(CAT)questionnaire
chronic obstructive pulmonary disease(COPD)
age
condition evaluation
