The Borg dyspnoea score: a relevant clinical marker of inspiratory muscle weakness in amyotrophic lateral sclerosis

被引:39
作者
Just, N. [1 ,2 ]
Bautin, N. [1 ]
Danel-Brunaud, V. [3 ]
Debroucker, V. [2 ]
Matran, R. [2 ]
Perez, T. [1 ,2 ]
机构
[1] CHRU, Clin Malad Resp, Lille, France
[2] CHRU, Serv Explorat Fonct Resp, Lille, France
[3] CHRU, Serv Neurol A, Lille, France
关键词
Amyotrophic lateral sclerosis; Borg scale; respiratory muscle strength; SNIFF NASAL; NEUROMUSCULAR DISEASE; RESPIRATORY-FUNCTION; PULMONARY-FUNCTION; MOUTH PRESSURE; SURVIVAL; SLEEP; ALS; VENTILATION; PREDICTORS;
D O I
10.1183/09031936.00184908
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
The aim of the study was to determine whether the Borg dyspnoea scale could be a useful and simple marker to predict respiratory muscle weakness in amyotrophic lateral sclerosis (ALS). From April 1997 to 2001, respiratory function was perfomed in 72 patients together with the Borg score in both the upright (uBorg) and supine (sBorg) positions. Mean upright vital capacity (VC) was 81 +/- 24% predicted, sniff nasal inspiratory pressure (SNIP) was 55 +/- 26% pred, maximal inspiratory pressure (P(I,max)) was 57 +/- 26% pred and arterial carbon dioxide tension (P(a,CO2)) was 41 +/- 6 mmHg. The mean Borg scores in the upright and supine positions were 1.7 +/- 1.5 and 2.2 +/- 2, respectively. A significant relationship between SNIP and uBorg (r=0.4; p=0.0007) and SNIP and sBorg (r=0.58; p<0.0001) was observed. Upright VC, Delta VC (measured as the supine fall in VC as a percentage of seated VC), P(I,max) and P(a,CO2) were significantly correlated with SNIP. A cut-off value of 3 on the sBorg scale provided the best sensitivity (80%) and specificity (78%) (area under the curve 0.8) to predict a SNIP <= 40 cmH(2)O, indicating severe inspiratory muscle weakness. Patients with a sBorg score >= 3 also exhibited significantly lower VC, P(I,max) and twitch mouth pressure during cervical magnetic stimulation, and slightly higher P(a,CO2) (43.7 +/- 7 versus 39.2 +/- 5 mmHg; p=0.05). The Borg dyspnoea scale is a valuable noninvasive test for the prediction of inspiratory muscle weakness in ALS patients.
引用
收藏
页码:353 / 360
页数:8
相关论文
共 33 条
[1]   Effect of noninvasive positive-pressure ventilation on survival in amyotrophic lateral sclerosis [J].
Aboussouan, LS ;
Khan, SU ;
Meeker, DP ;
Stelmach, K ;
Mitsumoto, H .
ANNALS OF INTERNAL MEDICINE, 1997, 127 (06) :450-453
[2]  
[Anonymous], 1999, CHEST, V116, P521
[3]   Sleep disorders and diaphragmatic function patients with amyotrophic lateral sclerosis [J].
Arnulf, I ;
Similowski, T ;
Salachas, F ;
Garma, L ;
Mehiri, S ;
Attali, V ;
Behin-Bellhesen, V ;
Meininger, V ;
Derenne, JP .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2000, 161 (03) :849-856
[4]  
*ASS NEUR LIB LANG, 2006, PRACT GUID CAR PAT A
[5]  
BLACK LF, 1971, AM REV RESPIR DIS, V103, P641
[6]   PSYCHOPHYSICAL BASES OF PERCEIVED EXERTION [J].
BORG, GAV .
MEDICINE AND SCIENCE IN SPORTS AND EXERCISE, 1982, 14 (05) :377-381
[7]   Effects of non-invasive ventilation on survival and quality of life in patients with amyotrophic lateral sclerosis [J].
Bourke, SC ;
Tomlinson, M ;
Williams, TL ;
Bullock, RE ;
Shaw, PJ ;
Gibson, GJ .
LANCET NEUROLOGY, 2006, 5 (02) :140-147
[8]   Respiratory function vs sleep-disordered breathing as predictors of QOL in ALS [J].
Bourke, SC ;
Shaw, PJ ;
Gibson, GJ .
NEUROLOGY, 2001, 57 (11) :2040-2044
[9]   El Escorial revisited: Revised criteria for the diagnosis of amyotrophic lateral sclerosis [J].
Brooks, BR ;
Miller, RG ;
Swash, M ;
Munsat, TL .
AMYOTROPHIC LATERAL SCLEROSIS AND OTHER MOTOR NEURON DISORDERS, 2000, 1 (05) :293-299
[10]   RESPIRATORY-FAILURE AND SLEEP IN NEUROMUSCULAR DISEASE [J].
BYE, PTP ;
ELLIS, ER ;
ISSA, FG ;
DONNELLY, PM ;
SULLIVAN, CE .
THORAX, 1990, 45 (04) :241-247