呼吸困难可视模拟评分在AECOPD中指导激素使用的价值

目的探讨呼吸困难可视模拟评分在AECOPD病人中的临床使用价值,初步评估其在指导糖皮质激素使用方面的作用。方法收集2013年12月至2014年5月符合条件的AECOPD病人69例,在患者入院后及出院前24小时内采用呼吸困难可视Analog问卷、改良后Borg’s评分及英国医学研究学会的呼吸困难量表(m MRC)对病人进行评估,并收集实验室生化指标包括CRP,血气分析等。统计患者住院总时间及激素使用总时间,并分析激素治疗与患者呼吸困难评分之间的相关性。结果入院可视Analog问卷与Borg评分间有良好的一致性(r=0.936,P0.01),与m MRC评分间呈相关性(r=0.527,P0.01)。治疗前后患者VAS问卷明显下降;入院可视Analog问卷得分值与激素使用之间呈正相关(r=0.706,P0.01),相关回归分析示回归系数b=1.505,P0.01。结论可视Analog问卷(VAS)具有准确评估患者呼吸困难的作用,临床上可用于指导AECOPD患者激素使用。

Application value of dyspnea visual analog scale in directing glucocorticoid usage in AECOPD patients

Objective To analyze the application of dyspnea VAS in the management of patients with AE-COPD, and to explore the value of the preliminary VAS assessment in guiding hormone use of AECOPD. Methods＆amp;nbsp;69 AECOPD patients completed VAS, Modified Borg’s score （MBS）, and modified Medical Research Council 24 hours before admission and discharge. The concentration of serum C-reactive protein （ CRP） , blood gas analysis, the duration of hospital stay and time exposed to glucocorticoid therapy were analyzed. Correlations between VAS, MBS and hormone therapy were examined. Results VAS at admission remained a good consistency with Borg score （ r=0. 936, P〈0. 01）, and a moderate correlation with mMRC score （r=0. 527, P〈0. 01）. After hormonal therapy, VAS and Modified Borg’ s score decreased significantly. VAS at admission was positively correlated with the duration of glucocorticoid usage （r=0. 706, P〈0. 01）. Conclusion VAS at admission can exactly assess AECOPD pa-tients’ dyspnea, which can guide the usage of glucocorticoid.