Gizem DEMİR, Ruşina DOĞAN, Gülseren KARABIYIKOĞLU, Sevgi SARYAL, Öznur AKKOCA

KOAH'da dispne ve yaşam kalitesinin değerlendirilmesi

Kişinin soluk alıp verdiğini rahatsızlık duyacak şekilde hissetmesi olarak tanımlanan dispne, kronik obstrüktif akciğer hastalığı (KOAH) olan hastaların en önemli şikayetidir. Altta yatan mekanizmalar dispnenin birçok sebebinin olduğunu göstermektedir. Bu çalışmanın amacı; KOAH'da dispneye neden olan mekanizmaları araştırmak ue ayrıca fonksiyonel parametreler, dispne skalaları ve yaşam kalitesi anketleri ile aralarındaki ilişkiyi irdelemektir. Bu amaçla çalışmaya 56 (l l kadın, 45 erkek) hasta alındı. Hastalara; akım hızlan, akciğer volümleri, solunum kas gücü, difüzyon kapasitesi, solunum paternini içeren solunum fonksiyon testleri ile arter kan gazlan ue bunların yanı sıra dispne skorları [MRC, Baseline Dyspnea Index (BDI)] ve "The Saint George Respiratory Questionnaire (SGRQ)" uygulandı. Grupların tümünde orta dereceli obstrüksiyon (%FEV1= 59.02 ± 3.30) ve orta dereceli hipoksemi ile hava hapsi (%RV/TLC= 52.00 ± 2.00) vardı. MRCskalası solunum fonksiyon parametreleri ile anlamlı korelasyon göstermezken, BDI ile akım hızları, Plmax, DLCO, hava hapsi ue solunum paterni parametreleri arasında anlamlı korelasyon saptandı (p< 0.001). SGRQ skorları ile FEVj, Plmax, RV/TLC ue PaO2 arasında anlamlı korelasyon bulundu. Ayrıca, BDI ile SRGQ skorları arasında kuvvetli korelasyon gözlendi. Sonuç olarak; KOAH'lı hastalarda dispne, yaşam kalitesini önemli ölçüde etkileyen, hava yolu kısıtlanması, solunum kas gücünün azalması, solunum paterninin değişmesi ve hava hapsi gibi birçok faktörün sonucu olan bir semptomdur.

The evaluation of dyspnea and quality of life in COPD

Dyspnea defined as an uncomfortable sensation of breathing is the main cause of disability in chronic obstructive pulmonary disease (COPD) patients. There is evidence that the underlying mechanisms of dyspnea are multifactorial. The aim of this study was to investigate these mechanisms causing dyspnea in COPD patients and the relationship between functional parameters, dyspnea scales and quality of life questionnaire. For this purpose 56 patients (11 female, 45 male) were recruited. Pulmonary function tests including airflow rates, lung volumes, maximal respiratory muscle forces, diffusing capacity, breathing pattern, arterial blood gas analyses as well as dyspnea scales MRC, baseline dyspnea index (BDI) andThe Saint George Respiratory Questionnaire (SGRQ) were performed. The overall group showed moderate obstructioe disease (FEV1 %= 59.02 ± 3.30) and mild hypoxemia with some air trapping (RV/TLC%= 52.00 ± 2.00). MRC scale did not show any significant correlation with pulmonary function parameters. There was significant positiue correlation between BDl and airflow rates, PImax, DLCO and air trapping. Breathing pattern parameters (Ti/Ttot, VT/Ti) also correlated with BDI. There Was positiue correlation between PaC>2 and BDl (p< 0.001). SGRQ scores correlated significantly with FEVj, PImax, RV/TLC and pqj. There was also strong correlation between BDI and SGRQ scores. In conclusion, dyspnea is the result of multiple factors such as airflow limitation, decreased respiratory muscle strength, changes breathing pattern, hypoxemia, and air trapping which in turn affects quality of life in patients with COPD.

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