University Lille 2, Lille; Service de Pneumologie et Immunoallergologie, Centre des Compétences des Maladies Pulmonaires Rares, Hôpital Calmette, Lille.
University Lille 2, Lille; Service de Pneumologie et Immunoallergologie, Centre des Compétences des Maladies Pulmonaires Rares, Hôpital Calmette, Lille.
Chest. 2013 Nov;144(5):1652-1658. doi: 10.1378/chest.13-0806.
The 6-min walk test (6MWT) is commonly used to assess exercise capacity in patients with fibrotic idiopathic interstitial pneumonia (f-IIP). However, it is not known whether patients with f-IIP have reduced levels of physical activity in daily life (DLPA) or whether pulmonary function tests and the 6MWT correlate with their DLPA.
The aim of this study was to measure DLPA in patients with f-IIP and to determine the relationships between DLPA and the 6MWT, pulmonary functional parameters, and anxiety and depression scores. Fifty patients with f-IIP and 25 sex- and age-matched healthy control subjects were enrolled. Markers of DLPA were assessed with a physical activity monitor for 4 consecutive days. Hospital Anxiety and Depression Scale (HADS) scores were evaluated.
DLPA parameters were significantly reduced in patients with f-IIP compared with control subjects (all P < .001). The mean number of steps per day correlated strongly with diffusing capacity of the lung for carbon monoxide (Dlco), FVC, the 6MWT distance, and the 6MWT lowest oxygen saturation as measured by pulse oximetry (Spo₂). DLPA was unrelated to HADS scores. Multivariate analysis showed that Dlco and 6MWT distance explained only 31% of the variance in the number of steps per day. Dlco, 6MWT distance, 6MWT lowest Spo₂, and DLPA were significant predictors of mortality, but only Dlco and 6MWT distance were independent predictors.
Quantitation of DLPA is a novel patient-centered approach to assess function in f-IIP and may be a useful tool for clinical care and assessing response to therapy.
6 分钟步行试验（6MWT）常用于评估纤维化特发性间质性肺炎（f-特发性间质性肺炎）患者的运动能力。然而，目前尚不清楚 f-特发性间质性肺炎患者在日常生活中（DLPA）的体力活动水平是否降低，以及肺功能检查和 6MWT 是否与他们的 DLPA 相关。
本研究旨在测量 f-特发性间质性肺炎患者的 DLPA，并确定 DLPA 与 6MWT、肺功能参数以及焦虑和抑郁评分之间的关系。共纳入 50 例 f-特发性间质性肺炎患者和 25 名性别和年龄匹配的健康对照者。使用活动监测器连续 4 天评估 DLPA 标志物。评估医院焦虑和抑郁量表（HADS）评分。
与健康对照组相比，f-特发性间质性肺炎患者的 DLPA 参数显著降低（均 P <.001）。每天的平均步数与一氧化碳弥散量（Dlco）、FVC、6MWT 距离以及脉搏血氧饱和度仪（Spo₂）测量的 6MWT 最低血氧饱和度强烈相关。DLPA 与 HADS 评分无关。多变量分析显示，Dlco 和 6MWT 距离仅能解释每天步数变化的 31%。Dlco、6MWT 距离、6MWT 最低 Spo₂ 和 DLPA 是死亡率的显著预测因子，但只有 Dlco 和 6MWT 距离是独立的预测因子。
DLPA 的定量是评估 f-特发性间质性肺炎患者功能的一种新颖的以患者为中心的方法，可能是临床护理和评估治疗反应的有用工具。
