de Oliveira N C, dos Santos Sabbag L M, Ueno L M, de Souza R B C, Borges C L, de Sá Pinto A L, Lima F R
Rheumatology Division, University of Sao Paulo, Brazil.
Scand J Rheumatol. 2007 Nov-Dec;36(6):458-61. doi: 10.1080/03009740701605889.
To evaluate the exercise capacity of women with systemic sclerosis (SSc) without pulmonary involvement using a cardiopulmonary stress test.
Thirteen consecutive female SSc patients [mean age 40.8+/-14 years, mean body mass index (BMI) 25.5+/-3.7 kg/m2] without pulmonary and cardiac involvement and 13 healthy sedentary female controls (mean age 41.6+/-9.1 years, mean BMI 23.7+/-3.8 kg/m2) matched by age and BMI underwent a maximum cardiopulmonary stress test (Bruce protocol). The following parameters were analysed: peak oxygen uptake (VO2peak), anaerobic threshold (AT), respiratory compensation point (RCP) and metabolic equivalent (MET) of the VO2peak. Comparisons between groups were analysed using the Student t-test.
Forced vital capacity (FVC; 92.2+/-14.2% predicted) and carbon monoxide diffusion lung capacity (DL CO; 85.8+/-5.8% predicted) were within the normal range in SSc patients. VO2peak of SSc patients was significantly reduced in comparison to the control group (19.8+/-4.6 vs. 23.7+/-4.5 mL/kg/min, p = 0.04). SSc patients also had a significant reduction in MET at peak exercise (5.6+/-1.3 vs. 6.7+/-1.3 MET, p = 0.04) and a significant shorter time interval between AT and RCP compared to the control group (112.6+/-95.6 vs. 164.0+/-65.3 s, p = 0.03).
SSc patients without pulmonary impairment have reduced exercise capacity. Abnormal vascular response to exercise may account for this finding, as the vascular system is one of the major target organs in this pathological condition.
使用心肺应激试验评估无肺部受累的系统性硬化症（SSc）女性的运动能力。
13例连续的无肺部和心脏受累的女性SSc患者[平均年龄40.8±14岁，平均体重指数（BMI）25.5±3.7kg/m²]和13例年龄及BMI相匹配的久坐不动的健康女性对照者（平均年龄41.6±9.1岁，平均BMI 23.7±3.8kg/m²）接受了最大心肺应激试验（Bruce方案）。分析了以下参数：峰值摄氧量（VO2peak）、无氧阈值（AT）、呼吸补偿点（RCP）以及VO2peak的代谢当量（MET）。使用学生t检验分析组间差异。
SSc患者的用力肺活量（FVC；预测值的92.2±14.2%）和一氧化碳弥散肺容量（DL CO；预测值的85.8±5.8%）在正常范围内。与对照组相比，SSc患者的VO2peak显著降低（19.8±4.6对23.7±4.5mL/kg/min，p = 0.04）。SSc患者在运动峰值时的MET也显著降低（5.6±1.3对6.7±1.3MET，p = 0.04），并且与对照组相比，AT和RCP之间的时间间隔显著缩短（112.6±95.6对164.0±65.3秒，p = 0.03）。
无肺部损害的SSc患者运动能力降低。运动时血管反应异常可能解释了这一发现，因为血管系统是这种病理状态下的主要靶器官之一。
