日本呼吸器学会雑誌第45巻第2号
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- のぶあき つくとの
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2 ADL: Feeding Transfer Dressing Bathing IADL: Shopping Transportation Table1 Spector-KatzIndex * ADL-IADLisevaluatedbythesum ofeachscore(0:totaly dependent,6:totalyindependent) Table2 Generalcharacteristicsofthepatients Age(years) Male/Female Height(cm) BMI MRCscale BDIfocalscore GOLD stage PaO2 (Torr) PaCO2 (Torr) VC (ml) VC (% predicted) FEV1 (ml) FEV1 (% predicted) FEV1/FVC (%) 6MWD (m) ΔSpO2(%) Borgscaleafterthe6-minutewalk COPD (n=111) 70± 7 104:7 161± ± ,2-23,3-40,4-40, ± 1.9 I-2,I-21, I-45,IV ± 11.1 *26caseswerebreathingoxygen. 43.7± 7.4 2,580± ± ± ± ± ± ± ± 2.0 non-copd (n=93) 69± 6 69:24 159± ± ,2-15,3-34, ± ± 10.8 *34caseswerebreathingoxygen. 47.0± 8.4 1,740± ± ,080± ± ± ± ± ± 2.2 BMI:bodymassindex,BDI:BaselineDyspneaIndex,VC:vitalcapacity,FEV1:forcedexpiratoryvolumein1second, FVC:forcedvitalcapacity,6MWD:6-minutewalkingdistance,Δ SpO2:oxygendesaturationduringthe6-minutewalk.
3 Fig.1 ADL-IADLscore A:COPD group,b:non-copd group
4 Table3 Accuracyindeterminingthelevelthreerespiratoryhandicapsusingthecurrentcriteria A.A lcases B.COPD C.non-COPD D.Interstitiallungdisease Fig.2 SimplelogisticregressioncurvesshowingtherelationbetweenADL-IADLscoreandFEV1Index (A),and6-minutewalkingdistance(B)inpatientswithCOPD. TheY-axisindicatestheprobabilityofanADL-IADLscoreof4orless.Whenthe6-minutewalkingdistanceis270m,theprobabilityofanADL-IADLscoreof4orlessis50%.
5 Fig.3 Cross-tableanalysesbetweenADL-IADLscoreandGOLD stage(a),supplementaloxygenuse(b), andmrcscale(c)inpatientswithcopd.
6 Table4 MultivariatelogisticregressionmodelestimatinginpatientswithCOPD from thethreeselectedparameters Estimation SD χ 2 p 95% CI, upperlimitlowerlimit Oddsratio Intercept MRCgrade(1-3/4,5) MWD (270m) Supplementaloxygen(+ /-) < p< ,R 2 =0.341 Abbreviationsareshownintable1. Fig.4 SimplelogisticcurvesshowingtherelationbetweenADL-IADLscoreandFEV1index(A),and6- minutewalkingdistance(b)in patientswithnon-copd lungdisease. Y-axisindicatestheprobabilityofanADL-IADLscoreof4orless.When6-minutewalkingdistanceis255 m,theprobabilityofadl-iadlscoreof4orlessis50%. Fig.5 Cross-tableanalysesbetweenADL-IADLscoreandsupplementaloxygenuse(A),andMRCscale (B)inpatientswithnon-COPD lungdisease.
7 Table5 Multivariatelogisticregressionmodelestimatinginpatientswithnon-COPD lungdiseasefrom thethreeselectedparameters Estimation SD χ 2 p 95% CI, upperlimit lowerlimit Oddsratio Intercept MRCgrade(1-3/4,5) MWD (255m) Supplementaloxygen(+ /-) p< ,R 2 =0.328 Fig.6 SimplelogisticcurvesshowingtherelationbetweenADL-IADLscoreandFEV1Index(A),and6- minutewalkingdistance(b)inpatientswithinterstitiallungdisease. TheY-axisindicatestheprobabilityofanADL-IADLscoreof4orless.When6-minutewalkingdistance is280m,theprobabilityofanadl-iadlscoreof4orlessis50%. Fig.7 ROCcurves,FEV1Index(A)and6-minutewalkingdistance(B)
8 Table6 Accuracyindeterminingthelevelthreerespiratoryhandicapusingthenew criteria A.A lcases B.COPD C.non-COPD D.Interstitiallungdisease Table7 Predictiveabilityofthecurrentandnew criteriaforadl Sensitivity Specificity PPV NPV Overalaccuracy A lcases currentcriteria new criteria COPD currentcriteria new criteria Non-COPD currentcriteria new criteria Interstitiallungdisease currentcriteria new criteria PPV:positivepredictivevalue,NPV:negativepredictivevalue
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