Schoindre Yoland, Meune Christophe, Dinh-Xuan Anh Tuan, Avouac Jérôme, Kahan André, Allanore Yannick
Université Paris Descartes, Service de Rhumatologie A, Département de Cardiologie, and Service Physiologie et Explorations Fonctionnelles, Hôpital Cochin, AP-HP, 75014 Paris, France.
J Rheumatol. 2009 Jul;36(7):1481-5. doi: 10.3899/jrheum.081221. Epub 2009 Jun 1.
The 6-minute walk test (6MWT) is an important prognostic tool in various cardiovascular diseases and has been considered as a surrogate endpoint. However, conflicting results have been reported in systemic sclerosis (SSc). Our objective was to evaluate the relationships of the 6-min walking distance (6MWD) and organ damage in SSc.
Eighty-seven consecutive patients with SSc were included and prospectively investigated; they underwent 6MWT in addition to conventional assessment of possible lung, heart, kidney, skin, and muscle involvement, and disease activity scoring, severity, and quality of life determination.
Twenty-six patients (30%) had an abnormal 6MWT and the mean 6MWD was 461.8 +/- 103.0 m. When considering 6MWT as a binary variable - normal or abnormal - C-reactive protein (CRP) was the only independent variable associated with abnormal 6MWT. Considered as a continuous variable, the 6MWD was associated with measures of lung involvement and inflammation, with the activity and severity of disease, and also with quality of life; nevertheless, calcinosis was the only independent factor associated in multivariate analyses with a trend for an association for CRP.
The 6MWD relates to broad factors in SSc and these results raise doubts about the specificity of the 6MWD in this systemic disease, and its relevance to monitoring therapy.
6分钟步行试验（6MWT）是多种心血管疾病的重要预后工具，被视为替代终点。然而，系统性硬化症（SSc）的相关研究结果存在矛盾。我们的目的是评估SSc患者6分钟步行距离（6MWD）与器官损害之间的关系。
纳入87例连续的SSc患者并进行前瞻性研究；除了对可能的肺、心、肾、皮肤和肌肉受累情况进行常规评估以及疾病活动评分、严重程度和生活质量测定外，他们还接受了6MWT。
26例患者（30%）6MWT异常，平均6MWD为461.8±103.0米。将6MWT视为二元变量（正常或异常）时，C反应蛋白（CRP）是与6MWT异常相关的唯一独立变量。将6MWD视为连续变量时，其与肺受累和炎症指标、疾病活动度和严重程度以及生活质量相关；然而，钙质沉着是多变量分析中唯一与CRP存在关联趋势的独立因素。
SSc患者的6MWD与多种因素相关，这些结果对6MWD在这种全身性疾病中的特异性及其与监测治疗的相关性提出了质疑。
