CAJ | 학술논문

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( mMRC)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,P<0．01),与mMRC评分间呈相关性(r=0．527,P<0．01)。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,P<0．01),相关回归分析示回归系数b=1．505,P<0．01。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。
목적：탐토호흡곤난가시모의평분재AECOPD병인중적림상사용개치,초보평고기재지도당피질격소사용방면적작용。방법수집2013년12월지2014년5월부합조건적AECOPD병인69례,재환자입원후급출원전24소시내채용호흡곤난가시Analog문권、개량후Borg’ s평분급영국의학연구학회적호흡곤난량표( mMRC)대병인진행평고,병수집실험실생화지표포괄CRP,혈기분석등。통계환자주원총시간급격소사용총시간,병분석격소치료여환자호흡곤난평분지간적상관성。결과입원가시Analog문권여Borg평분간유량호적일치성(r=0．936,P<0．01),여mMRC평분간정상관성(r=0．527,P<0．01)。치료전후환자VAS문권명현하강；입원가시Analog문권득분치여격소사용지간정정상관(r=0．706,P<0．01),상관회귀분석시회귀계수b=1．505,P<0．01。결론가시Analog문권( VAS)구유준학평고환자호흡곤난적작용,림상상가용우지도AECOPD환자격소사용。
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 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.