在慢性阻塞性肺疾病(COPD)患者中应用的BODE指数中,用最大耗氧量替代6分钟步行试验:一项等效性研究。

Replacement of the 6-min walk test with maximal oxygen consumption in the BODE Index applied to patients with COPD: an equivalency study.

作者信息

Cardoso Fábio, Tufanin Andréa Thomazine, Colucci Marcelo, Nascimento Oliver, Jardim José Roberto

机构信息

Respiratory Division (Pneumologia/Unifesp), 04023-062, São Paulo SP, Brazil.

出版信息

Chest. 2007 Aug;132(2):477-82. doi: 10.1378/chest.07-0435. Epub 2007 May 15.

Abstract

INTRODUCTION

Patients with COPD have decreased exercise capacity and low oxygen consumption (Vo(2)) during formal cardiopulmonary exercise testing, and lower scores on health-related quality of life questionnaires. When isolated, these three variables show different correlations with COPD mortality. The multidimensional BODE (body mass index[BMI], airflow obstruction, dyspnea, and exercise capacity in COPD) index, which comprises four variables including the 6-min walk test (6MWT), predicts survival in COPD.

OBJECTIVES

To evaluate the degree of association between the values of the BODE index using the 6MWT with the BODE index using maximal Vo(2) (Vo(2)max) obtained in a maximal incremental test.

MATERIALS AND METHODS

Fifty patients with mild-to-severe COPD (average age, 63.5 +/- 9.9 years; FEV(1), 65.3 +/- 23.6% of predicted) [+/- SD] had BMI, spirometric function (FVC and FEV(1)), and dyspnea status (Medical Research Council) evaluated. Two BODE index scores were then completed: one with the 6MWT, and one with the Vo(2)max obtained during maximal incremental testing on a treadmill.

RESULTS

Correlation between BODE index and Vo(2) in milliliters per minute per kilogram (r = - 0.41) was weak; the correlation was moderate (r = - 0.64) when Vo(2) percentage of predicted was used. The BODE index modified by replacing the 6MWT with Vo(2) showed excellent correlations with Vo(2) in milliliters per minute per kilogram (r = 0.92) and Vo(2) percentage of predicted (r = 0.95).

CONCLUSION

The excellent correlation between the conventional BODE index and the modified BODE index with Vo(2) replacing the 6MWT enables us to reach the conclusion that the original BODE index is very effective in the evaluation of COPD patients.

摘要

引言

慢性阻塞性肺疾病(COPD)患者在正式的心肺运动试验中运动能力下降且耗氧量(Vo₂)较低,在健康相关生活质量问卷上得分也较低。单独来看,这三个变量与COPD死亡率呈现不同的相关性。多维BODE(COPD中的体重指数[BMI]、气流阻塞、呼吸困难和运动能力)指数包含四个变量,其中包括6分钟步行试验(6MWT),可预测COPD患者的生存率。

目的

评估使用6MWT得出的BODE指数值与在最大递增试验中获得的最大耗氧量(Vo₂max)得出的BODE指数之间的关联程度。

材料与方法

50例轻至重度COPD患者(平均年龄63.5±9.9岁;第1秒用力呼气容积[FEV₁]为预测值的65.3±23.6%)[±标准差]接受了BMI、肺量计功能(用力肺活量[FVC]和FEV₁)以及呼吸困难状况(医学研究委员会)评估。然后完成两个BODE指数评分:一个使用6MWT,另一个使用在跑步机上进行最大递增试验时获得的Vo₂max。

结果

BODE指数与每分钟每千克毫升的Vo₂之间的相关性较弱(r = -0.41);当使用预测Vo₂百分比时,相关性为中等(r = -0.64)。用Vo₂替代6MWT修正后的BODE指数与每分钟每千克毫升的Vo₂(r = 0.92)和预测Vo₂百分比(r = 0.95)显示出极好的相关性。

结论

传统BODE指数与用Vo₂替代6MWT的修正BODE指数之间的极好相关性使我们能够得出结论,即原始BODE指数在评估COPD患者方面非常有效。

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