Caminati Antonella, Bianchi Achille, Cassandro Roberto, Mirenda Maria Rosa, Harari Sergio
Unità Operativa di Pneumologia e Terapia Semi-Intensiva Respiratoria - Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare Ospedale San Giuseppe Fatebenefratelli, Via San Vittore 12, 20123 Milan, Italy.
Respir Med. 2009 Jan;103(1):117-23. doi: 10.1016/j.rmed.2008.07.022. Epub 2008 Sep 10.
Idiopathic pulmonary fibrosis (IPF) is a progressive disease with high mortality rates and a median survival of 2-3 years from time of diagnosis. The prognosis for any individual patient, however, is variable. To elucidate the clinical significance of 6-min walking test (6-MWT) in patients with IPF, we sought to assess the relationship between distance walked and desaturation during this test and pulmonary function tests (PFTs). We also evaluate the prognostic value of 6-MWT in comparison with PFTs at baseline and during follow-up.
The clinical data of 44 patients with IPF were retrospectively analysed. Twenty-nine patients had an additional evaluation after 12 month of follow-up.
Distance walked in 6 min was independently related to mortality by multivariate analysis. Patients walking less then 212 m had a significantly lower survival than those walking farther, assessed by Kaplan-Meier survival curves (log-rank test, p<0.036). During a mean follow-up period of 19.8 months (range 3.2-46.4), 11 patients died of causes related to disease. Changes in meters walked at 12 months evaluation were also predictive of survival (p=0.05).
These results confirm that in IPF distance walked in 6 min is independent associated with mortality.
特发性肺纤维化(IPF)是一种进展性疾病,死亡率高,诊断后中位生存期为2至3年。然而,任何个体患者的预后都存在差异。为了阐明6分钟步行试验(6-MWT)在IPF患者中的临床意义,我们试图评估该试验期间步行距离与血氧饱和度下降以及肺功能测试(PFTs)之间的关系。我们还比较了6-MWT与基线及随访期间PFTs的预后价值。
对44例IPF患者的临床资料进行回顾性分析。29例患者在随访12个月后进行了额外评估。
多因素分析显示,6分钟步行距离与死亡率独立相关。通过Kaplan-Meier生存曲线评估(对数秩检验,p<0.036),步行距离小于212米的患者生存率明显低于步行更远的患者。在平均19.8个月(范围3.2 - 46.4个月)的随访期内,11例患者死于与疾病相关的原因。12个月评估时步行距离的变化也可预测生存率(p = 0.05)。
这些结果证实,在IPF患者中,6分钟步行距离与死亡率独立相关。