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六分钟步行试验在终末期肾病预期寿命中的预后价值:一项前瞻性队列研究。

Prognostic value of the six-minute walk test in end-stage renal disease life expectancy: a prospective cohort study.

机构信息

Institute of Cardiology of Rio Grande do Sul, University Foundation of Cardiology, Porto Alegre, RS, Brazil.

出版信息

Clinics (Sao Paulo). 2012;67(6):581-6. doi: 10.6061/clinics/2012(06)06.

DOI:10.6061/clinics/2012(06)06
PMID:22760895
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3370308/
Abstract

OBJECTIVES

The six-minute walk test has been widely used to evaluate functional capacity and predict mortality in several populations. Thus, the aim of this study was to evaluate the prognostic value of the six-minute walk test for the life expectancy of end-stage renal disease patients.

METHODS

Patients over 18 years old who underwent hemodialysis for at least six months were included. Patients with hemodynamic instability, smoking, chronic obstructive pulmonary disease, physical incapacity and acute myocardial stroke in the preceding three months were excluded.

RESULTS

Fifty-two patients (54% males; 36+11 years old) were followed for 144 months. The distance walked in the six-minute walk test was a survival predictor for end-stage renal disease patients. In the multivariate analysis, for each 100 meters walked with a 100-meter increment, the hazard ratio was 0.53, with a 95% confidence interval of 0.37-0.74. There was a positive correlation between the distance walked in the six-minute walk test and peak oxygen consumption (r = 0.508). In the multivariate analysis, each year of dialysis treatment represented a 10% increase in death probability; in the severity index analysis, each point on the scale represented an 11% increase in the death risk.

CONCLUSIONS

We observed that survival increased approximately 5% for every 100 meters walked in the six-minute walk test, demonstrating that the test is a viable option for evaluating the functional capacity in patients with end-stage renal disease.

摘要

目的

六分钟步行试验已广泛用于评估多种人群的功能能力和预测死亡率。因此,本研究旨在评估六分钟步行试验对终末期肾病患者预期寿命的预后价值。

方法

纳入至少接受六个月血液透析的 18 岁以上患者。排除血流动力学不稳定、吸烟、慢性阻塞性肺疾病、身体残疾和三个月内急性心肌梗死者。

结果

52 名患者(54%为男性;36+11 岁)随访 144 个月。六分钟步行试验中行走的距离是终末期肾病患者的生存预测因素。在多变量分析中,每增加 100 米行走距离,风险比为 0.53,95%置信区间为 0.37-0.74。六分钟步行试验中行走的距离与峰值耗氧量呈正相关(r=0.508)。在多变量分析中,每次透析治疗代表死亡概率增加 10%;在严重程度指数分析中,量表上的每一点代表死亡风险增加 11%。

结论

我们观察到,六分钟步行试验中行走的距离每增加 100 米,生存率约增加 5%,表明该试验是评估终末期肾病患者功能能力的可行选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6edf/3370308/e8c9c0ef36ce/cln-67-06-581-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6edf/3370308/6af595a2ff58/cln-67-06-581-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6edf/3370308/e8c9c0ef36ce/cln-67-06-581-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6edf/3370308/6af595a2ff58/cln-67-06-581-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6edf/3370308/e8c9c0ef36ce/cln-67-06-581-g002.jpg

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