呼吸道疾病诊断评价工具介绍.pptVIP

* Physicians and patients need to be able to measure the impact of COPD in a standarised way. Improved fact-based dialogue between patients and physicians, whereby both are speaking the same language, is crucial to help patients communicate the impact of their disease, facilitating a common understanding, and thus assisting in improving the management of COPD. /content/58/3/226.full * * * * COPD 全球診療指引 (2011) 2011年COPD全球診療指引將COPD病患的嚴重程度依據風險、症狀及惡化病史分為四個象限。 風險：用藥後的肺功能 測試 症狀：mMRC或CAT問卷 惡化：住院或其他惡化 指標 第一秒用力吐氣量 (FEV1) 為何需要相關問卷來評估：醫師和病患必須有相同的語言來衡量COPD的狀況 我想我應該沒什麼問題 妳最近情況好嗎? 我還好但是在爬樓梯的時候會有點喘，不知道這該不該說出來 一個月前 妳上一次離開家裡是什麼時候? 病患和醫師必須有共同且客觀的標準來了解COPD的嚴重程度 病患必須真實的描述自身的狀況 COPD臨床診斷可輔助使用的工具 目前已有數種有效的問卷可被用來評估COPD 病人的症狀，COPD全球治療指引建議使用 1. 修訂版英國醫學研究會問卷 （the modified British Medical Research Council；mMRC）或是 2. COPD 評估測試（COPD Assessment Test；CAT） mMRC 問卷可預測未來死亡的風險，CAT 問卷則廣泛涵蓋病人的日常生活及身心健康受疾病影響的程度。 修訂版醫學研究委員會呼吸困難量表 (mMRC) Fletcher CM, Elmes PC, Wood CH. The significance of respiratory symptoms and the diagnosis of chronic bronchitis in a working population. BMJ. 1959;2:257-266 通常用來追蹤病患在門診後的病情狀況或是於肺部復健時的評量指標 MRC量表最早在1952年由學者Fletcher提出，之後被快速的應用在評估各種心肺功能疾病的追蹤。mMRC量表被証實與各種肺功能的測試或其他呼吸困難的指標有高度的相關性，亦可直接評估病患失能，在臨床上是非常實用的判斷工具。 Modified medical research council questionnaire for assessing the severity of breathlessness mMRC Scope Grade 0 Grade 1 Grade 2 Grade 3 Grade 4 Description I only get breathless with strenuous exercise I get short of breath when hurrying on the level or walking up a slight hill. I walk slower than people of the same age on the level because of breathlessness, or I have to stop for breath when walking on my own pace on the level. I stop for breath after walking about 100 meters or after a few minutes on the level. I am too breathless to leave the house or I am breathless when dressing or undressing. Fletcher CM, Elmes PC, Wood CH. The significance of respiratory symptoms and the diagnosis of chronic bronchitis in a working population. B mMRC量表