Hallstrand T S, Boitano L J, Johnson W C, Spada C A, Hayes J G, Raghu G
Dept of Medicine, Division of Pulmonary and Critical care Medicine, University of Washington, Seattle, WA 98195-6522, USA.
Eur Respir J. 2005 Jan;25(1):96-103. doi: 10.1183/09031936.04.00137203.
Idiopathic pulmonary fibrosis (IPF) is a relentlessly progressive disease with a median survival of approximately 3 yrs. Measurements of airflow and lung volumes at rest are generally used to monitor the clinical course in this disorder. This study was designed to determine if a modified version of the 6-min walk test, called the timed walk test, accurately characterises disease severity and survival in IPF. The study population consisted of 28 patients with well-characterised progressive IPF. The timed walk test and concurrent measures of disease severity were assessed at baseline. Participants were prospectively followed for > or =4 yrs to determine the relationship between parameters of the timed walk test and survival. There were strong correlations between the end-exercise saturation and walk-velocity parameters of the timed walk test and diffusing capacity, and arterial oxygen tension at rest. In univariate Cox proportional-hazards models, end-exercise saturation, change in saturation with exercise, walk distance and walk velocity were associated with survival. In unadjusted logistic regression models, odds of death at 2 yrs were associated with the same parameters. In conclusion, the timed walk test relates to disease severity and long-term outcome in progressive idiopathic pulmonary fibrosis.
特发性肺纤维化(IPF)是一种进展性疾病,中位生存期约为3年。通常使用静息时气流和肺容量的测量来监测该疾病的临床进程。本研究旨在确定一种名为定时步行试验的改良版6分钟步行试验是否能准确表征IPF的疾病严重程度和生存期。研究人群包括28例特征明确的进行性IPF患者。在基线时评估定时步行试验及同时进行的疾病严重程度测量。对参与者进行前瞻性随访≥4年,以确定定时步行试验参数与生存期之间的关系。定时步行试验的运动结束时饱和度和步行速度参数与弥散能力以及静息时动脉血氧张力之间存在很强的相关性。在单变量Cox比例风险模型中,运动结束时饱和度、运动时饱和度变化、步行距离和步行速度与生存期相关。在未调整的逻辑回归模型中,2年时的死亡几率与相同参数相关。总之,定时步行试验与进行性特发性肺纤维化的疾病严重程度和长期预后相关。