Rusanov Victorya, Shitrit David, Fox Ben, Amital Anat, Peled Nir, Kramer Mordechai R
Department of Internal Medicine B, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Respir Med. 2008 Jul;102(7):1080-8. doi: 10.1016/j.rmed.2007.12.031. Epub 2008 May 23.
Idiopathic pulmonary fibrosis (IPF) is often associated with exercise-induced hypoxemia. Although maximal oxygen consumption (VO2(max)) is considered the gold-standard index of functional capacity in IPF, its measurement requires sophisticated equipment and trained personnel. The aim of the present study was to investigate the value of the simple 15-steps climbing exercise oximetry test in patients with IPF. The 15-steps climbing test was administered to 51 patients with IPF. Pulmonary function tests (PFTs), cardiopulmonary exercise test (CPET), and the 6-min walk distance (6MWD) test were performed in the same session. Oxygen saturation in the 15-steps climbing test was measured by continuous oximetry, and quantified oxygen desaturation was determined by calculating the area under the curve of oxygen saturation from the beginning of exercise through the lowest desaturation point until recovery to baseline ("desaturation area"). There was a statistically significant correlation between all parameters of the 15-steps climbing test and both VO2(max)) on the CPET (lowest saturation, p=0.002, r=0.43; saturation difference, p=0.02, r=-0.33; recovery time, p=0.02, r=-0.32; and desaturation area, p=0.005, r=-0.39), and carbon dioxide diffusion in the lungs (DLCO) on the PFTs (lowest saturation, p=0.0001, r=0.52; saturation difference, p=0.0002, r=-0.50; recovery time, p=0.0001, r=-0.53; and desaturation area, p=0.0001, r=-0.53). On stepwise linear regression analysis, independent significant predictors of VO2(max) were lowest saturation on the 15-steps test and the 6MWD. We concluded that the 15-steps oximetry test is a simple and accurate bedside tool for the evaluation of functional capacity in patients with IPF.
特发性肺纤维化（IPF）常与运动性低氧血症相关。尽管最大摄氧量（VO2(max)）被认为是IPF患者功能能力的金标准指标，但其测量需要精密设备和训练有素的人员。本研究的目的是探讨简单的15级爬楼运动血氧饱和度测试在IPF患者中的价值。对51例IPF患者进行了15级爬楼测试。在同一时段进行了肺功能测试（PFT）、心肺运动测试（CPET）和6分钟步行距离（6MWD）测试。通过连续血氧饱和度测定法测量15级爬楼测试中的血氧饱和度，并通过计算从运动开始到最低血氧饱和度点直至恢复到基线的血氧饱和度曲线下面积（“血氧饱和度降低面积”）来确定定量的血氧饱和度降低情况。15级爬楼测试的所有参数与CPET上的VO2(max)（最低饱和度，p = 0.002，r = 0.43；饱和度差异，p = 0.02，r = -0.33；恢复时间，p = 0.02，r = -0.32；血氧饱和度降低面积，p = 0.005，r = -0.39）以及PFT上的肺二氧化碳弥散量（DLCO）（最低饱和度，p = 0.0001，r = 0.52；饱和度差异，p = 0.0002，r = -0.50；恢复时间，p = 0.0001，r = -0.53；血氧饱和度降低面积，p = 0.0001，r = -0.53）之间存在统计学显著相关性。在逐步线性回归分析中，VO2(max)的独立显著预测因素是15级测试中的最低饱和度和6MWD。我们得出结论，15级血氧饱和度测试是评估IPF患者功能能力的一种简单而准确的床边工具。
