ABSTRACT
Objective To explore the clinical value and significance of the chronic obstructive pulmonary disease (COPD) assessment test (CAT) in patients with acute exacerbation of COPD (AECOPD).Methods A prospective observational study was conducted,AECOPD patients were admitted to the Department of Respiration Medicine in Jiaxing Second Hospital from February 2011 to July 2016 were enrolled,and they all underwent CAT assessment test and lung function examination.The patients were assigned to Ⅱ,Ⅲ and Ⅳ grade groups according to the lung function level,and the difference of forced expiratory end volume in 1 second (FEV1) and FEV1/forced vital capacity (FVC) ratio were compared among the three groups;the patients were also assigned into 2,3 and 4 grade groups according to CAT scores,and the difference of length of stay in the hospital and hospitalization expenses were compared among the three groups.Spearman correlation analysis was used to analyze the correlations between the CAT score and lung function indexes.Results One hundred and thirty-five patients with AECOPD were accepted and all of their clinical data were analyzed in the study.Their mean FEV1 was (0.42±0.16) L,FEV1/FVC was 0.44 ±0.13 and CAT score was 26.64 ± 5.43.The correlation analyses showed:there were significant negative correlations between CAT score and FEV1,FEV1/FVC (r value was-0.691,-0.728,both P ＜ 0.001).With the elevation of lung function grade,FEV1 and FEV1/FVC were decreased gradually (1Ⅱ,Ⅲ,Ⅳ grade groups were 0.62±0.07,0.40±0.06,0.25±0.03 and 0.64±0.01,0.40±0.00,0.33±0.06 respectively),while CAT score raised gradually (20.03 ± 3.36,28.30 ± 3.31,30.18±3.86,all P ＜ 0.01);with the CAT score getting higher and higher,hospitalization expenses (yuan) and the length of stay in hospital (day) of patients with AECOPD were increased significantly (2,3,4 grade groups:expense were 6214.09±1396.16,8339.31±1866.46,9600.97±4339.87,and length of stay in hospital were 7.54± 1.62,9.52±2.21,14.85 ±5.62,respectively,all P ＜ 0.01).Conclusion CAT is a reliable tool to measure the life quality of AECOPD patients and has certain relevance to the severity and prognosis of the disease.
ABSTRACT
Objective To explore the effectiveness of a respiratory function training instrument with stable chronic obstructive pulmonary disease (COPD) patients.Methods Sixty-seven COPD patients in the stable period were randomly divided into a treatment group of 36 and a control group of 31 using a random number table.Both groups were given conventional pulmonary rehabilitation,including half-closed lip respiration,abdominal respiration and upper limb training.The treatment group was additionally provided with 30 minutes of respiratory training using a respiration function training instrument 5 times per week for 6 months.Both groups were assessed for their mobility,life quality and pulmonary function using the 6-minute walk test (6 MWT),a COPD assessment test (CAT),the BODE index,forced vital capacity (FVC),forced expiratory volume in one second (FEV1) and surface electromyography (SEMG) of the respiratory muscles before and after the 6-month intervention.Results Before the treatment there were no significant differences between the two groups in terms of any of the measurements.After the treatment,significant improvement was observed in the average 6 MWT,CAT,BODE index and SEMG results in both groups,but with significantly greater improvement in the treatment group.The average FVC and FEV1 results did not improve significantly,so after the intervention there was still no significant difference between the groups.Conclusions Respiratory training using the pulmonary function training instrument can improve the mobility,life quality and the functioning of the respiratory muscles of COPD patients in the stable period.