سنجش ارتباط ایندکس بالینی BODE با ظرفیت‌های دینامیک ریوی و پروفایل آمادگی هوازی بیماران آسم مزمن چاق

نوع مقاله: مقاله پژوهشی

نویسندگان

1 گروه فیزیولوژی، دانشکده علوم ورزشی، دانشگاه بوعلی سینا، همدان، همدان، ایران.

2 گروه داخلی، دانشکده پزشکی، دانشگاه علوم پزشکی اراک، اراک، ایران.

3 دانشکده توانبخشی، دانشگاه علوم پزشکی تهران، تهران، ایران.

چکیده

زمینه و هدف: نقش ایندکس BODE شامل پارامترهای BMI ،FEV1،DSI  و ظرفیت ورزشی( 6 دقیقه راه رفتن) در پیش­بینی مرگ و میر، ابقاء زندگی، دوره بستری، میزان تشدید یا بهبود بیماری و تاثیر مداخلات توان­بخشی بیماران تنفسی آشکار شده است. اما وابستگی این ایندکس با عوامل اسپیرومتری و پروفایل آمادگی هوازی بیماران آسم مزمن چاق پیکر مشخص نمی­باشد.
روش بررسی: 27 مرد میان سال مبتلا به آسم مزمن خفیف و متوسط با دامنۀ سنی 33 تا 54 سال و میانگین نمایه جرم بدن  6/2 ± 32/31  کیلوگرم بر مترمربع و ظرفیت عملی پایه 43/0± 72/2 لیتر در دقیقه داوطلبانه شرکت نمودند. سطح ضایعه و اندازۀ تنگی نفس بر حسب دستورالعمل NYHA تعیین گردید. ظرفیت­های دینامیک ریوی پایه به روش استاندارد KNUDSON و پروفایل آمادگی شامل (Vo2/HR) ، (VO2/WR) و VO2peak بوسیله پروتکل ارگومتری YMCA تعیین شدند. ظرفیت ورزشی مطابق دستورلعمل ATS و سنجش ایندکس BODE نیز به روش Celli انجام گرفت.
یافته­ها: پارامترهای تنفسی FVC ، FEV1 ، FEV1/FVC ، PEF% و  FEF25% -75%، شاخص­های آمادگی و ظرفیت ورزشی وابستگی معنادار با امتیاز BODE نداشتند(5%p>). اما FVC% پایه با شاخص کارسنجی (VO2/WR) ارتباط معناداری مشاهده گردید (45%=p و 39%=r).
نتیجه­گیری: امتیاز ایندکس  BODEدر مردان میانسال مبتلا به آسم خفیف و متوسط احتمالا ابزار تشخیصی معتبر در مطالعه نیمرخ تغییرات ظرفیت­های ریوی یا پروفایل هوازی آنان مناسب بنظر نمی­رسد. با این حال،اعتبارسنجی امتیاز مولفه های BODE، جایگزینی پارامترهای جدید یااصلاح این ایندکس بالینی درجمعیت­های بزرگتر بیماران آسم برونشیال مزمن چاق پیکر، به مطالعات تجربی بعدی نیازمندمی­باشد.

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