COPD 患者における嚥下困難の症状について

Symptoms of dysphagia in patients with COPD.

抄録

目的:

COPD患者における嚥下困難の症状を、自己認識質問票の回答に基づいて明らかにすること。

OBJECTIVE: To identify symptoms of dysphagia in individuals with COPD, based on their responses on a self-perception questionnaire.

方法:

年齢と性別をマッチさせた35名のCOPD患者および35名の健常者を対象とした。COPD重症度、呼吸困難感、肥満度（BMI）、嚥下困難の症状について調査した。対照群はBMIと嚥下困難の症状について評価した。

METHODS: The study comprised 35 individuals with COPD and 35 healthy individuals, matched for age and gender. The study group was assessed regarding COPD severity; sensation of dyspnea; body mass index (BMI); and symptoms of dysphagia. The control group was assessed regarding BMI and symptoms of dysphagia.

結果:

研究グループにおいて最も多かった嚥下障害の症状は、咽頭症状／気道保護（p＜0.001）、食道症状／肺炎の既往（p＜0.001）、栄養症状（p＜0.001）であった。以下の変数の組の間に正の相関がみられた。FEV₁とBMI（r＝0.567，p＜0.001），咽頭症状・気道保護と呼吸困難（r＝0.408，p＝0.015），食道症状・肺炎歴と咽頭症状・気道保護（r＝0.531，p＝0.001），であった．栄養症状とBMIの間には負の相関があった（r = -0.046; p < 0.008）。

RESULTS: The most common symptoms of dysphagia in the study group were pharyngeal symptoms/airway protection (p < 0.001); esophageal symptoms/history of pneumonia (p < 0.001); and nutritional symptoms (p < 0.001). Positive correlations were found between the following pairs of variables: FEV₁ and BMI (r = 0.567; p < 0.001); pharyngeal symptoms/airway protection and dyspnea (r = 0.408; p = 0.015); and esophageal symptoms/history of pneumonia and pharyngeal symptoms/airway protection (r = 0.531; p = 0.001). There was a negative correlation between nutritional symptoms and BMI (r = -0.046; p < 0.008).

結論:

COPD患者には嚥下障害症状がみられ、嚥下の咽頭期と食道期、気道保護機構、肺炎の既往、栄養症状などと関連することが示された。

CONCLUSIONS: Our results show that the individuals with COPD presented with symptoms of dysphagia that were associated with the pharyngeal and esophageal phases of swallowing, as well as with the mechanism of airway protection, a history of pneumonia, and nutritional symptoms.