Research Division, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York 10021, USA.
Lupus. 2012 Oct;21(12):1343-50. doi: 10.1177/0961203312456750. Epub 2012 Aug 8.
Although pulmonary involvement is common in systemic lupus erythematosus (SLE), its effects on healthy lifestyle physical activity and its association with fatigue have not been well characterized. The goals of this study were to describe pulmonary function measured by office-based spirometry in patients with SLE and to compare spirometry with physical activity and systemic fatigue.
During an office visit, 49 patients with SLE completed spirometry assessing: a) forced expiratory volume in 1 s (FEV(1), a measure of airway patency and responsiveness); b) forced vital capacity (FVC, a measure of lung volume); and c) maximum voluntary ventilation (MVV, a measure of volume of air moved during rapid breathing) which has been hypothesized to be decreased in SLE due to muscle fatigue. Patients also performed a 2-min corridor walking test and completed self-reported questionnaires measuring weekly physical activity and systemic fatigue.
Mean age was 45 years, 45 (92%) were women, mean SLEDAI and SLICC scores were 2.8 and 1.0, respectively. Some 24 patients had a smoking history, and 15 had a history of SLE-related pleuritis, which was not active at enrollment. FEV(1) and FVC were 96% of predicted, but MVV was only 55% of predicted. The distance walked during the corridor test was similar to that of patients with other chronic diseases; however, self-reported physical activity was less than recommended by national guidelines. There were no associations between spirometry values and history of pleuritis, other pulmonary diagnoses, or smoking (p > .10 for all comparisons), however, better FEV(1) (p = .04) and better FVC (p = .04) were associated with more self-reported activity and better FEV(1) (p = .03) was associated with longer distance walked during the corridor test. Most patients reported marked systemic fatigue; however, there were no associations between spirometry values and fatigue scores (p > .10 for all comparisons).
MVV was markedly diminished, which supports the hypothesis that SLE may be associated with respiratory muscle fatigue during rapid breathing. MVV was not associated with mild-to-moderate patient-directed physical activity; however, lower FEV(1) and FVC were associated with less self-reported and performance-based physical activity.
尽管肺部受累在系统性红斑狼疮（SLE）中很常见，但它对健康生活方式体力活动的影响及其与疲劳的关系尚未得到很好的描述。本研究的目的是描述通过办公室基础肺量计测量的 SLE 患者的肺功能，并将肺量计与体力活动和全身疲劳进行比较。
在一次就诊期间，49 名 SLE 患者完成了肺量计评估：a）第 1 秒用力呼气量（FEV1，用于评估气道通畅性和反应性）；b）用力肺活量（FVC，用于评估肺容积）；c）最大自主通气量（MVV，用于评估快速呼吸时空气的容量），由于肌肉疲劳，MVV 已被假设在 SLE 中降低。患者还进行了 2 分钟走廊步行测试，并完成了自我报告的问卷，以衡量每周的体力活动和全身疲劳。
平均年龄为 45 岁，45 名（92%）为女性，平均 SLEDAI 和 SLICC 评分为 2.8 和 1.0。24 名患者有吸烟史，15 名患者有 SLE 相关胸膜炎病史，但在入组时无活动。FEV1 和 FVC 为预测值的 96%，但 MVV 仅为预测值的 55%。走廊测试中的行走距离与其他慢性疾病患者相似；然而，自我报告的体力活动低于国家指南推荐的水平。肺量计值与胸膜炎史、其他肺部诊断或吸烟史之间没有关联（所有比较的 p 值均>0.10），然而，更好的 FEV1（p=0.04）和更好的 FVC（p=0.04）与更多的自我报告活动相关，更好的 FEV1（p=0.03）与走廊测试中行走的距离更长相关。大多数患者报告有明显的全身疲劳；然而，肺量计值与疲劳评分之间没有关联（所有比较的 p 值均>0.10）。
MVV 明显减少，这支持 SLE 可能与快速呼吸时呼吸肌疲劳有关的假设。MVV 与轻度至中度患者导向的体力活动无关；然而，较低的 FEV1 和 FVC 与较少的自我报告和基于表现的体力活动相关。
