目的 探讨呼吸困难指数气流受限程度指数(dyspnea index air flow restriction degree，ADO)在慢性阻塞性肺疾病(chronic obstructive pulmonary disease，COPD)患者近期预后评估中的价值。方法 选取新疆医科大学第二附属医院呼吸内科自 2021 年 3 月—2023 年 3 月的COPD患者 120 例，并依照患者最终转归情况将其分为存活组(n=95)与死亡组(n=25)。观察 2 组患者的基础病情况及患者性别、年龄、第 1 秒用力呼气容积(first second forced expiratory volume，FEV1)占预计值的百分比和ADO指数等相关指标。比较ADO指数不同分数患者病死率。比较ADO指数预测 180 d死亡的受试者工作特征(receiver operating characteristic，ROC)曲线面积。结果 2 组患者的高血压、冠心病、心律失常、糖尿病、慢性肝病、慢性肾病、亚临床甲减发生情况对比，差异无统计学意义(P＞0。05)。死亡组患者的FEV1 占预计值的百分比、FEV1 占预计值的百分比评分、呼吸困难分[英国医学研究委员会(the Medical Research Council，MRC)]评分以及ADO指数均高于存活组患者(P＜0。05)。ADO指数＜5 分者的死亡率高于ADO指数≥5 分者(P＜0。05)。ADO指数预测 180 d死亡的ROC曲线面积为 0。851(95%CI:0。767～0。928，P＜0。001)，ADO指数为 5。5 时，约登指数最大，为 0。565。结论 ADO可有效反映COPD病情严重程度，对于患者而言可准确反映其病情进展情况，帮助其获得良好的疾病治疗效果，对于患者近期预后而言也具有积极意义，临床应用效果良好。
The Value of ADO in Short-Term Prognosis Evaluation of Patients With Chronic Obstructive Pulmonary Disease
Objective To explore the value of dyspnea index air flow restriction degree(ADO)in long-term prognosis evaluation of patients with chronic obstructive pulmonary disease(COPD).Methods A total of 120 patients with chronic obstructive pulmonary disease admitted to department of respiratory,the Second Affiliated Hospital of Xinjiang Medical University from March 2021 to March 2023.They were divided into two groups based on their final outcome:the survival group(n=95)and the death group(n=25).The basic disease conditions of the two groups of patients were observed separately.Patient gender,age,the percentage of the first second forced expiratory volume(FEV1)as expected values,and ADO index related indicators were compered.Mortality rates among patients with different scores of ADO index were compered.receiver operating characteristic(ROC)curve area for predicting 180 d mortality using ADO index was compered.Results The incidence of hypertension,coronary heart disease,arrhythmia,diabetes,chronic liver disease,chronic kidney disease and subclinical hypothyroidism in the two groups were compared,the difference was not statistically significant(P>0.05).The percentage of FEV1 to expected value,percentage of,FEV1 to expected value score,the Medical Research Council(MRC)score,and ADO index of patients in the death group were higher than those in the survival group(P<0.05).The mortality rate of individuals with ADO index<5 points was higher than that of individuals with ADO index≥5 points(P<0.05).The ROC curve area predicted by the ADO index for 180 d mortality was 0.851(95%CI:0.767 to 0.928,P<0.001).When the ADO index was 5.5,the Jordan index was the highest,reaching 0.565.Conclusion ADO can effectively reflect the severity of COPD.For patients,it can accurately reflect their progress and help them achieve good disease treatment results.It also has positive significance for long-term prognosis of patients.The clinical application effect is good.
dyspnea index air flow restriction degreechronic obstructive pulmonary diseaseShort-Term prognosislung functionevaluationclinical value
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