Win T, Jackson A, Groves A M, Sharples L D, Charman S C, Laroche C M
Thoracic Oncology Unit, Papworth Hospital, Cambridge, UK.
Thorax. 2006 Jan;61(1):57-60. doi: 10.1136/thx.2005.043547. Epub 2005 Oct 21.
The relationship between the shuttle walk test and peak oxygen consumption in patients with lung cancer has not previously been reported. A study was undertaken to examine this relationship in patients referred for lung cancer surgery to test the hypothesis that the shuttle walk test would be useful in this clinical setting.
125 consecutive patients with potentially operable lung cancer were prospectively recruited. Each performed same day shuttle walking and treadmill walking tests.
Shuttle walk distances ranged from 104 m to 1020 m and peak oxygen consumption ranged from 9 to 35 ml/kg/min. The shuttle walk distance significantly correlated with peak oxygen consumption (r = 0.67, p<0.001). All 55 patients who achieved more than 400 m on the shuttle test had a peak oxygen consumption of at least 15 ml/kg/min. Seventy of 125 patients failed to achieve 400 m on the shuttle walk test; in 22 of these the peak oxygen consumption was less than 15 ml/kg/min. Nine of 17 patients who achieved less than 250 m had a peak oxygen consumption of more than 15 ml/kg/min.
The shuttle walk is a useful exercise test to assess potentially operable lung cancer patients with borderline lung function. However, it tends to underestimate exercise capacity at the lower range compared with peak oxygen consumption. Our data suggest that patients achieving 400 m on the shuttle walk test do not require formal measurement of oxygen consumption. In patients failing to achieve this distance we recommend assessment of peak oxygen consumption, particularly in those unable to walk 250 m, because a considerable proportion would still qualify for surgery as they had an acceptable peak oxygen consumption.
此前尚未报道过肺癌患者往返步行试验与最大摄氧量之间的关系。本研究旨在对因肺癌手术前来就诊的患者进行此项关系的研究，以验证往返步行试验在此临床环境中是否有用的假设。
前瞻性招募了125例连续的具有潜在手术指征的肺癌患者。每位患者均在同一天进行往返步行试验和跑步机步行试验。
往返步行距离为104米至1020米，最大摄氧量为9至35毫升/千克/分钟。往返步行距离与最大摄氧量显著相关（r = 0.67，p<0.001）。在往返试验中步行超过400米的所有55例患者，其最大摄氧量至少为15毫升/千克/分钟。125例患者中有70例在往返步行试验中未达到400米；其中22例患者的最大摄氧量低于15毫升/千克/分钟。在步行距离不足250米的17例患者中，有9例的最大摄氧量超过15毫升/千克/分钟。
往返步行试验是评估肺功能临界的潜在可手术肺癌患者的有用运动试验。然而，与最大摄氧量相比，它在较低范围内往往会低估运动能力。我们的数据表明，在往返步行试验中达到400米的患者无需进行正式的耗氧量测量。对于未达到此距离的患者，我们建议评估最大摄氧量，尤其是那些无法步行250米的患者，因为相当一部分患者的最大摄氧量仍可接受，仍有资格进行手术。
