Nishiyama Osamu, Taniguchi Hiroyuki, Kondoh Yasuhiro, Kimura Tomoki, Kato Keisuke, Ogawa Tomoya, Watanabe Fumiko, Arizono Shinichi
Department of Respiratory Medicine and Allergy, Tosei General Hospital, 160 Nishioiwake-cho, Seto, Aichi 489-8642, Japan.
Respir Med. 2007 Apr;101(4):833-8. doi: 10.1016/j.rmed.2006.06.030. Epub 2006 Sep 8.
The characteristics of dyspnoea in idiopathic pulmonary fibrosis (IPF) during a 6-min walk test are not clear. This study was designed to evaluate dyspnoea and desaturation during the 6-min walk test in IPF in comparison with that in chronic obstructive pulmonary disease (COPD), which is one of the most studied chronic lung diseases. The 41 consecutive patients with IPF included in this study were assessed by a 6-min walk test and concurrent measures of disease severity. Forty-one age-matched and resting PaO(2) value-matched COPD patients who had undertaken the test during the same period were selected as the control. Only O(2) saturation at the end of the test was an independent predictor of dyspnoea in IPF (r(2)=0.27, P=0.0005), whereas forced expiratory volume in 1s (FEV(1)) was the only predictor in COPD (r(2)=0.16, P=0.0096). Desaturation was significantly more severe in IPF (83.6+/-9.1% in IPF versus 88.0+/-5.9% in COPD, P<0.001). In contrast, dyspnoea assessed with the Borg scale was significantly more severe in COPD (3.6+/-2.1 in IPF versus 4.6+/-1.9 in COPD, P<0.05). O(2) saturation is an independent predictor of dyspnoea at the end of a 6-min walk test in IPF. In comparison with COPD, desaturation is more severe, although dyspnoea is milder.
特发性肺纤维化(IPF)患者在6分钟步行试验中的呼吸困难特征尚不清楚。本研究旨在评估IPF患者在6分钟步行试验期间的呼吸困难和血氧饱和度下降情况,并与慢性阻塞性肺疾病(COPD)(研究最多的慢性肺病之一)进行比较。本研究纳入的41例连续IPF患者通过6分钟步行试验及疾病严重程度的同步测量进行评估。选择41例年龄匹配且静息PaO₂值匹配、同期进行该试验的COPD患者作为对照。在IPF中,仅试验结束时的血氧饱和度是呼吸困难的独立预测因素(r² = 0.27,P = 0.0005),而在COPD中,1秒用力呼气容积(FEV₁)是唯一的预测因素(r² = 0.16,P = 0.0096)。IPF患者的血氧饱和度下降明显更严重(IPF为83.6±9.1%,COPD为88.0±5.9%,P < 0.001)。相比之下,用Borg量表评估的呼吸困难在COPD中明显更严重(IPF为3.6±2.1,COPD为4.6±1.9,P < 0.05)。血氧饱和度是IPF患者6分钟步行试验结束时呼吸困难的独立预测因素。与COPD相比,IPF患者的血氧饱和度下降更严重,尽管呼吸困难较轻。