日常体力活动量和强度与 COPD 严重程度的关系。

Association of daily physical activity volume and intensity with COPD severity.

机构信息

Department of Sports Medicine, Institute of Exercise and Health Sciences, University of Basel, Brüglingen 33, CH-4052 Basel, Switzerland.

出版信息

Respir Med. 2011 Dec;105(12):1846-52. doi: 10.1016/j.rmed.2011.07.003. Epub 2011 Jul 30.

DOI:10.1016/j.rmed.2011.07.003

PMID:21803556

Abstract

PURPOSE

The purpose of this study was to assess whether daily walking activity is indicative of disease severity in patients with COPD.

METHODS

Daily activity was measured by accelerometry in 107 COPD: GOLD II (N=28), GOLD III (N=51), and GOLD IV (N=25). Steps per day and times (min/day) spent passively, actively, walking (WLK, 0-5 km/h), and fast walking (FWLK, >5 km/h) were analyzed. Total walking time (TWT) was computed.

RESULTS

Times spent WLK (P=0.031), FWLK (P=0.001), TWT (P=0.021), and steps per day (P=0.013) differed significantly between GOLD stages. There was a significant negative correlation between TWK and GOLD stage (R=-0.35; P<0.0001), BODE index (R=-0.58; P<0.0001), and MMRC dyspnea scale (R=-0.65; P<0.0001). Logistic regression analysis showed that both TWT and FWLK were independently and significantly associated with BODE index ≥ 6 (P=0.029 and P=0.040, respectively). The corresponding AUC-value with 95% CI for TWT was 0.80 (95% CI: 0.70 to 0.90) and 0.87 (95% CI: 0.81 to 0.94) for FWLK. The corresponding optimal cut-off value for TWT was 33.3 min/day (sensitivity: 86%; specificity 70%) and FWLK was 0.10 min/day (sensitivity: 93%; specificity 76%).

CONCLUSION

Daily walking activity, in particular walking intensity, is significant predictor of disease severity in patients with COPD. Objective measures of habitual activity might provide additive value in assessing the likelihood of poor prognosis in this patient cohort.

摘要

目的

本研究旨在评估 COPD 患者的日常步行活动是否与疾病严重程度相关。

方法

107 例 COPD 患者（GOLD II：28 例，GOLD III：51 例，GOLD IV：25 例）接受加速度计测量日常活动。分析每日步数和被动、主动、步行（0-5km/h）和快走（>5km/h）的时间（min/天）。计算总步行时间（TWT）。

结果

GOLD 分期之间，步行时间（P=0.031）、快走时间（P=0.001）、TWT（P=0.021）和每日步数（P=0.013）差异有统计学意义。TWT 与 GOLD 分期（R=-0.35；P<0.0001）、BODE 指数（R=-0.58；P<0.0001）和 MMRC 呼吸困难量表（R=-0.65；P<0.0001）呈显著负相关。Logistic 回归分析显示，TWT 和 FWLK 均与 BODE 指数≥6 独立且显著相关（P=0.029 和 P=0.040）。TWT 的 AUC 值及其 95%CI 为 0.80（95%CI：0.70 至 0.90），FWLK 的 AUC 值及其 95%CI 为 0.87（95%CI：0.81 至 0.94）。TWT 的最佳截断值为 33.3min/天（敏感性：86%；特异性 70%），FWLK 的最佳截断值为 0.10min/天（敏感性：93%；特异性 76%）。