Cinsiyet faktörü algılanan efor dispne şiddetini etkiler mi?

Amaç: Kronik obstrüktif akciğer hastalığı olan olgularda egzersiz kapasitesinde azalma önemli bir morbidite nedenidir. Bu hastalarda gelişen egzersiz intoleransının erken dönem bulgusu efor dispnesi olarak tanımlanır. Efor dispnesi ve şiddetini belirlemek için basit olmaları nedeniyle Modifıye Borg Skalası ve Visüel Analog Skalası en sık kullanılan dispne skalalarıdır. Sadece hastaların ifadeleri ile yorumlanan bu skalaların cinsiyet faktöründen etkilenebileceği düşünülmüştür. Bu nedenle çalışmamız bahsedilen skalaların birbirleriyle ilişkisini ve cinsiyet faktörüne göre değişikliklerini analiz etmek amacıyla yapılmıştır. Gereç ve yöntem: Yas ortalamaları 66,4±9,9 yıl olan 60 orta-ağır şiddetli Kronik Obstrüktif Akciğer Hastası çalışmaya alınmıştır. Tüm olgulara istirahatte solunum fonksiyon testi, arter kan gazı analizi yapılarak, Kronik Solunum Hastalıkları Yaşam Kalitesi Anketinin dispne kategorisi sorgulanmış, 6 dakika yürüme testi sonucunda Modifıye Borg Skalası ve Visüel Analog Skalası ile dispne şiddeti değerlendirilmiştir. Bulgular: Kadın ve erkek olgularımızda egzersiz testi sonunda her iki skala ile tanımlanan dispne şiddetlerinin benzer olduğu bulunmuştur (p>0,05). Dispne şiddetinin; solunum fonksiyon testi ve arter kan gazı analizi parametrelerinden çok, egzersiz kapasitesi ve yaşam kalitesi ölçümleriyle ilişkili olduğu, ayrıca erkek cinsiyetinde iki skala sonucunun birbiriyle güçlü derecede korele olduğu (r=0,41, p0,05) saptanmıştır. Sonuç: Dispne şiddetinin cinsiyet faktörü de göz önüne alınarak çok yönlü değer-lendirilmesinin daha doğru olacağı düşünülmüştür.

Anahtar Kelimeler:

Nefes darlığı, Akciğer hastalığı, kronik obstrüktif, Cinsiyet faktörleri, Solunum fonksiyon testleri, Egzersiz testi

Does the gender factor effect the perception of severity of exertion dyspnea?

Objective: Decrease in exercise capacity is an important morbidity cause with the patients of chronic obstructive pulmonary diseases. The exertion dyspnea is defined as early stage' symptom in these patients with exercise intolerance. Modified Borg Scale and Visuel Analog Scale are most widely used dyspnea scales, because of simple methods to evaluate the exertion dyspnea and it's severity. Interpretation of these scales is made only by patients answer, and results may be effected by gender factor. The purpose of this study was to investigate relationship between two scales and the gender effect on their output., Material and method: The mean age of 66,4±9,9, with modarate-severe 60 Chronic Obstructive Pulmonary Diseases patients included in this study. Pulmonary function test, arterial blood gase analysis and dyspnea categoric of the Chronic Respiratory Diseases Questionnaire were performed to all participants. Severity of exertion dyspnea was evaluated with Modified Borg Scale and Visuel Analog Scale at the end of 6 minute walking test. Results: The severity of dyspnea was similar in both males and fameles (p>0,05). A significant correlation was found between severity of dyspnea, and exercise capacity and life quality (r>0,42, p<0,001). Severity exertion dyspnea was not significantly correlated with pulmonary function and arterial blood gase analysis output (r>0,08, p>0,05). Correlation between two scales was found to be significant in males (r=0,41, p<0,05) and females (r=0,52, p>0,05). Conclusion: We concluded that gender factor may be taken into consideration during the assesnaent of severity of exertion dyspnea and multiple evaluation was very proper.

Keywords:

Dyspnea, Pulmonary Disease, Chronic Obstructive, Sex Factors, Respiratory Function Tests, Exercise Test,

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