Relationship of the changes between short-term life quality and forced expiratory volume in one second of pulmonary function in COPD patients_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

ZHANG Qiao , LI Hong , WANG Qinqin , LIU Lingjun ,  MA Qianli

Chronic Respiratory Disease Management and Rehabilitation Center, The North-Kuanren General Hospital, Chongqing 401121, P. R. China;

Corresponding?author：

MA Qianli, Email: cqmql@163.com

Keywords：

Chronic obstructive pulmonary disease; forced expiratory volume in one second; health-related life quality

DOI：

10.7507/1671-6205.202203034

Video：

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Objective To study the relationship between the changes of short-term health-related life quality and the improvement/deterioration of forced expiratory volume in one second (FEV₁) in patients with chronic obstructive pulmonary disease (COPD), and explore the feasibility of planning the frequency of pulmonary function test by evaluating the changes of life quality of COPD patients. Methods Based on the change of FEV₁ (△FEV₁), COPD patients from the standardized COPD and asthma management project database and its extended database of the center for chronic airway disease management, from 2020 to now, who completed pulmonary function tests and St. George's Respiratory Questionnaire (SGRQ) twice with an interval of 28 days, were divided into △FEV₁ improvement group, △FEV₁ deterioration group and △FEV₁ maintenance group. The differences of SGRQ scores in different △FEV₁ groups were analyzed, and the high-risk factors of △FEV₁ deterioration group and the importance of influencing factors of △FEV₁ deterioration were analyzed by neural network. Results A total of 1233 patients were included in the analysis. There were significant differences in △SGRQ total score, △SGRQ symptom, △SGRQ activity and △SGRQ impacts among △FEV₁ groups (P<0.05). Compared with the △FEV₁ maintenance group, the △FEV₁ improvement group showed clinically significant improvement in both the total SGRQ score and each sub score, and the improvement value was more than 4 points. While the △FEV₁ deterioration group showed statistically significant difference in the total SGRQ score and each sub score, but only showed clinically significant deterioration in the SGRQ symptom sub evaluation. Logistic regression model showed that the risk factors of △FEV₁ deterioration included female (OR=2.11, 95%CI 1.23 - 3.59, P=0.006), baseline FEV₁ (OR=2.63, 95%CI 1.92 - 3.60, P<0.001), △SGRQ (OR=1.02, 95%CI 1.01 - 1.03, P<0.001), baseline SGRQ symptom (OR=1.02, 95%CI 1.01 - 1.02, P<0.001) and △SGRQ symptom (OR=1.02, 95%CI 1.01 - 1.03, P<0.001), further neural network analysis showed that the importance orders of the five variables were △SGRQ total score (100.0%), △SGRQ symptom (86.9%), baseline FEV₁ (71.4%), baseline SGRQ symptom (56.6%) and gender (29.6%). Conclusions The variables of short-term health-related life quality assessment of COPD patients are helpful to predict the changes of pulmonary function improvement, but the ability to predict the changes of pulmonary function deterioration is limited. For patients with no changes or improvement in short-term health-related life quality assessment, it is still recommended to increase the frequency of pulmonary function test in order to detect the deterioration of pulmonary function early.

Citation： ZHANG Qiao, LI Hong, WANG Qinqin, LIU Lingjun, MA Qianli. Relationship of the changes between short-term life quality and forced expiratory volume in one second of pulmonary function in COPD patients. Chinese Journal of Respiratory and Critical Care Medicine, 2022, 21(4): 230-235. doi: 10.7507/1671-6205.202203034 Copy

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2.	Wang C, Xu JY, Yang L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health study): a national cross-sectional study. Lancet, 2018, 391(10131): 1706-1717.
3.	Zhou MG, Wang HD, Zeng XY, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2019, 394(10204): 1145-1158.
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8.	譚漫琳, 簡文星, 梁秋菊, 等. 不同評價系統對慢阻肺患者病情及治療療效的評估價值. 南方醫科大學學報, 2021, 41(7): 1119-1124.
9.	Jones PW. Health status and the spiral of decline. COPD, 2009, 6(1): 59-63.
10.	李海寧, 馬千里, 王長征, 等. 影響支氣管哮喘患者合并焦慮/抑郁情緒的多因素分析. 國際呼吸雜志, 2017, 37(23): 1761-1765.
11.	萬敏, 唐小婷, 張巧, 等. 哮喘–慢阻肺重疊綜合征患者 240 例臨床特征分析. 第三軍醫大學學報, 2015, 37(21): 2181-2185.
12.	Jones PW, Quirk FH, Baveystock CM. The St George's Respiratory Questionnaire. Respir Med, 1991, 85 Suppl B: 25-31; discussion 33-37.
13.	Jones PW, Quirk FH, Baveystock CM, et al. A self-complete measure of health status for chronic airflow limitation. The St. George's Respiratory Questionnaire. Am Rev Respir Dis, 1992, 145(6): 1321-1327.
14.	Domingo-Salvany A, Lamarca R, Ferrer M, et al. Health-related quality of life and mortality in male patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 2002, 166(5): 680-685.
15.	孫甜, 李曉云, 彭雅婷, 等. 慢性阻塞性肺疾病晨間癥狀與其他臨床特征的關系及相關因素分析. 中國呼吸與危重監護雜志, 2021, 20(6): 381-387.
16.	殷曉娜, 楊萬春. CAT 和 mMRC 評分系統在慢性阻塞性肺疾病病情評估中的應用價值分析. 中國現代醫藥雜志, 2021, 23(3): 19-22.
17.	周麗娟, 溫賢秀, 呂琴, 等. 使用機器學習建立慢性阻塞性肺疾病患者重度氣流受限風險預警模型研究. 中國全科醫學, 2022, 25(2): 217-226.
18.	de la Loge C, Tugaut B, Fofana F, et al. Relationship between FEV₁ and patient-reported outcomes changes: results of a meta-analysis of randomized trials in stable COPD. Chronic Obstr Pulm Dis, 2016, 3(2): 519-538.
19.	文富強, 陳磊. 中國慢性阻塞性肺疾病診療的現存問題與思考. 中華醫學雜志, 2020, 100(2): 81-84.
20.	李正歡, 張曉云, 陳楊, 等. 2020年慢性阻塞性肺疾病全球倡議《COPD診斷、治療與預防全球策略》指南解讀(一)—穩定期藥物管理. 中國全科醫學, 2021, 24(8): 923-929.

1. Fang LW, Gao P, Bao HL, et al. Chronic obstructive pulmonary disease in China: a nationwide prevalence study. Lancet Respir Med, 2018, 6(6): 421-430.
2. Wang C, Xu JY, Yang L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health study): a national cross-sectional study. Lancet, 2018, 391(10131): 1706-1717.
3. Zhou MG, Wang HD, Zeng XY, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2019, 394(10204): 1145-1158.
4. 中華醫學會呼吸病學分會慢性阻塞性肺疾病學組, 中國醫師協會呼吸醫師分會慢性阻塞性肺疾病工作委員會. 慢性阻塞性肺疾病診治指南(2021 年修訂版). 中華結核和呼吸雜志, 2021, 44(3): 170-205.
5. From the Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD). 2011. Available at: http://www.goldcopd.org/.
6. From the Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD). 2021. Available at: http://www.goldcopd.org/.
7. 梁振宇, 王鳳燕, 陳榮昌. 慢性阻塞性肺疾病診治指南(2021 年修訂版)的重要更新解讀及展望. 國際呼吸雜志, 2021, 41(19): 1457-1461.
8. 譚漫琳, 簡文星, 梁秋菊, 等. 不同評價系統對慢阻肺患者病情及治療療效的評估價值. 南方醫科大學學報, 2021, 41(7): 1119-1124.
9. Jones PW. Health status and the spiral of decline. COPD, 2009, 6(1): 59-63.
10. 李海寧, 馬千里, 王長征, 等. 影響支氣管哮喘患者合并焦慮/抑郁情緒的多因素分析. 國際呼吸雜志, 2017, 37(23): 1761-1765.
11. 萬敏, 唐小婷, 張巧, 等. 哮喘–慢阻肺重疊綜合征患者 240 例臨床特征分析. 第三軍醫大學學報, 2015, 37(21): 2181-2185.
12. Jones PW, Quirk FH, Baveystock CM. The St George's Respiratory Questionnaire. Respir Med, 1991, 85 Suppl B: 25-31; discussion 33-37.
13. Jones PW, Quirk FH, Baveystock CM, et al. A self-complete measure of health status for chronic airflow limitation. The St. George's Respiratory Questionnaire. Am Rev Respir Dis, 1992, 145(6): 1321-1327.
14. Domingo-Salvany A, Lamarca R, Ferrer M, et al. Health-related quality of life and mortality in male patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 2002, 166(5): 680-685.
15. 孫甜, 李曉云, 彭雅婷, 等. 慢性阻塞性肺疾病晨間癥狀與其他臨床特征的關系及相關因素分析. 中國呼吸與危重監護雜志, 2021, 20(6): 381-387.
16. 殷曉娜, 楊萬春. CAT 和 mMRC 評分系統在慢性阻塞性肺疾病病情評估中的應用價值分析. 中國現代醫藥雜志, 2021, 23(3): 19-22.
17. 周麗娟, 溫賢秀, 呂琴, 等. 使用機器學習建立慢性阻塞性肺疾病患者重度氣流受限風險預警模型研究. 中國全科醫學, 2022, 25(2): 217-226.
18. de la Loge C, Tugaut B, Fofana F, et al. Relationship between FEV₁ and patient-reported outcomes changes: results of a meta-analysis of randomized trials in stable COPD. Chronic Obstr Pulm Dis, 2016, 3(2): 519-538.
19. 文富強, 陳磊. 中國慢性阻塞性肺疾病診療的現存問題與思考. 中華醫學雜志, 2020, 100(2): 81-84.
20. 李正歡, 張曉云, 陳楊, 等. 2020年慢性阻塞性肺疾病全球倡議《COPD診斷、治療與預防全球策略》指南解讀(一)—穩定期藥物管理. 中國全科醫學, 2021, 24(8): 923-929.

Chinese Journal of Respiratory and Critical Care Medicine

Relationship of the changes between short-term life quality and forced expiratory volume in one second of pulmonary function in COPD patients

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