Blanco Isabel, Villaquirán Claudio, Valera José Luis, Molina-Molina María, Xaubet Antoni, Rodríguez-Roisin Robert, Barberà Joan A, Roca Josep
Servei de Pneumologia, Hospital Clínic, Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, España.
Arch Bronconeumol. 2010 Mar;46(3):122-8. doi: 10.1016/j.arbres.2009.12.005. Epub 2010 Feb 6.
The six-minute walk test (6MWT) is widely used in evaluating diffuse interstitial lung disease (ILD) and pulmonary hypertension (PH). However, their physiological determining factors have not been well defined.
To evaluate the physiological changes that occur in ILD and PH during the 6MWT, and compare them with the cardiopulmonary exercise test (CPET).
Thirteen patients with ILD and 14 with PH were studied using the 6MWT and CPET on an ergometer cycle. The respiratory variables were recorded by means of telemetry during the 6MWT.
Oxygen consumption (VO(2)), respiratory and heart rate reached a plateau from minute 3 of the 6MWT in both diseases. The VO(2) did not differ from the peak value in the CPET (14+/-2 and 15+/-2 ml/kg/min, respectively, in ILD; 16+/-6 and 16+/-6 ml/kg/min, in PH). The arterial oxygen saturation decreased in both diseases, although it was more marked in ILD (-12+/-5%, p<0,01). The ventilatory equivalent for CO(2) (V(E)/VCO(2)) in PH during the 6MWT was strongly associated with functional class (FC) (85+/-14 in FC III-IV, 44+/-6 in FC I-II; p<0,001).
The 6MWT in ILD and PH behaves like a maximal effort test, with similar VO(2) to the CPET, demonstrating a limit in oxygen transport capacity. Monitoring using telemetry during the 6MWT may be useful for the clinical evaluation of patients with ILD or PH.
六分钟步行试验（6MWT）广泛用于评估弥漫性间质性肺疾病（ILD）和肺动脉高压（PH）。然而，其生理决定因素尚未明确。
评估ILD和PH患者在6MWT期间发生的生理变化，并将其与心肺运动试验（CPET）进行比较。
对13例ILD患者和14例PH患者进行了6MWT和踏车CPET研究。在6MWT期间通过遥测记录呼吸变量。
两种疾病在6MWT的第3分钟时，耗氧量（VO₂）、呼吸频率和心率均达到平台期。ILD患者的VO₂与CPET中的峰值无差异（分别为14±2和15±2 ml/kg/min）；PH患者为16±6和16±6 ml/kg/min。两种疾病的动脉血氧饱和度均下降，尽管在ILD中更明显（-12±5%，p<0.01）。PH患者在6MWT期间的二氧化碳通气当量（V(E)/VCO₂）与功能分级（FC）密切相关（FC III-IV级为85±14，FC I-II级为44±6；p<0.001）。
ILD和PH患者的6MWT表现为最大运动试验，其VO₂与CPET相似，表明氧运输能力存在限制。在6MWT期间使用遥测进行监测可能有助于ILD或PH患者的临床评估。
