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结节病的六分钟步行试验与健康状况评估

Six-minute walk test and health status assessment in sarcoidosis.

作者信息

Baughman Robert P, Sparkman Brian K, Lower Elyse E

机构信息

Department of Internal Medicine, University of Cincinnati, Cincinnati, OH 45627, USA.

出版信息

Chest. 2007 Jul;132(1):207-13. doi: 10.1378/chest.06-2822.

Abstract

BACKGROUND

The 6-min walk test has proved useful in assessing impairment and prognosis in various lung diseases.

METHODS

A prospective study of 142 sarcoidosis patients seen during a 6-week period at one tertiary sarcoidosis clinic. All patients completed spirometry, 6-min walk testing, St. George Respiratory Questionnaire (SGRQ), fatigue assessment scale, and dyspnea score. Parameters assessed included the 6-min walk distance (6MWD) and the initial and lowest oxygen saturations during the test.

RESULTS

One hundred three of 142 patients had extrapulmonary manifestations, 10 patients had left ventricular dysfunction, and 14 patients had documented pulmonary hypertension. Seventy-three patients (51%) completed a 6MWD < 400 m, and 32 patients (22%) walked < 300 m. The 14 patients with documented pulmonary hypertension had a shorter 6MWD (median, 280 m; range, 61 to 404) than those without documented pulmonary arterial hypertension (median, 411 m; range, 46 to 747; p < 0.0001). Several components of the pulmonary function and quality of life correlated with 6MWD. Using a stepwise multiple regression analysis, only SGRQ activity component (t = - 7.498, p < 0.0001), FVC (t = 4.415, p < 0.0001), and lowest oxygen saturation (t = 2.55, p < 0.02) were independent predictors of 6MWD.

CONCLUSIONS

6MWD was reduced in the majority of sarcoidosis patients. Several factors were associated with a reduced 6MWD, including FVC, oxygen saturation with exercise, and self-reported respiratory health. Both 6MWD and quality of life measures are useful in assessing the functional status of sarcoidosis patients.

摘要

背景

6分钟步行试验已被证明在评估各种肺部疾病的损伤和预后方面很有用。

方法

对一家三级结节病诊所6周内诊治的142例结节病患者进行前瞻性研究。所有患者均完成了肺功能测定、6分钟步行试验、圣乔治呼吸问卷(SGRQ)、疲劳评估量表和呼吸困难评分。评估的参数包括6分钟步行距离(6MWD)以及试验期间的初始和最低血氧饱和度。

结果

142例患者中有103例有肺外表现,10例有左心室功能障碍,14例有记录的肺动脉高压。73例患者(51%)完成的6MWD<400米,32例患者(22%)步行距离<300米。有记录的肺动脉高压的14例患者的6MWD较短(中位数为280米;范围为61至404米),而无记录的肺动脉高压的患者6MWD较长(中位数为411米;范围为46至747米;p<0.0001)。肺功能和生活质量的几个组成部分与6MWD相关。采用逐步多元回归分析,只有SGRQ活动部分(t=-7.498,p<0.0001)、用力肺活量(FVC,t=4.415,p<0.0001)和最低血氧饱和度(t=2.55,p<0.02)是6MWD的独立预测因素。

结论

大多数结节病患者的6MWD降低。几个因素与6MWD降低有关,包括FVC、运动时的血氧饱和度和自我报告的呼吸健康状况。6MWD和生活质量测量均有助于评估结节病患者的功能状态。

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