Kim Changhwan, Park Yong Bum, Park So Young, Park Sunghoon, Kim Cheol-Hong, Park Sang Myeon, Lee Myung-Goo, Hyun In-Gyu, Jung Ki-Suck, Kim Dong-Gyu
Department of Pulmonary and Critical Care Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea. ; Lung Research Institute of Hallym University College of Medicine, Chuncheon, Korea.
Lung Research Institute of Hallym University College of Medicine, Chuncheon, Korea.
Yonsei Med J. 2014 May;55(3):732-8. doi: 10.3349/ymj.2014.55.3.732. Epub 2014 Apr 1.
A recent study demonstrated that exertional desaturation is a predictor of rapid decline in lung function in patients with chronic obstructive pulmonary disease (COPD); however, the study was limited by its method used to detect exertional desaturation. The main purpose of this study was to explore whether exertional desaturation assessed using nadir oxygen saturation (SpO₂) during the 6-minute walk test (6MWT) can predict rapid lung function decline in patients with COPD.
A retrospective analysis was performed on 57 patients with moderate to very severe COPD who underwent the 6MWT. Exertional desaturation was defined as a nadir SpO₂ of <90% during the 6MWT. Rapid decline was defined as an annual rate of decline in forced expiratory volume in 1 second (FEV₁)≥50 mL. Patients were divided into rapid decliner (n=26) and non-rapid decliner (n=31) groups.
A statistically significant difference in exertional desaturation was observed between rapid decliners and non-rapid decliners (17 vs. 8, p=0.003). No differences were found between the groups for age, smoking status, BODE index, and FEV₁. Multivariate analysis showed that exertional desaturation was a significant independent predictor of rapid decline in patients with COPD (relative risk, 6.8; 95% CI, 1.8 to 25.4; p=0.004).
This study supports that exertional desaturation is a predictor of rapid lung function decline in male patients with COPD.
最近一项研究表明，运动性低氧血症是慢性阻塞性肺疾病（COPD）患者肺功能快速下降的一个预测指标；然而，该研究受到其检测运动性低氧血症方法的限制。本研究的主要目的是探讨在6分钟步行试验（6MWT）期间使用最低氧饱和度（SpO₂）评估的运动性低氧血症是否能预测COPD患者的肺功能快速下降。
对57例中度至极重度COPD患者进行了6MWT的回顾性分析。运动性低氧血症定义为6MWT期间最低SpO₂<90%。快速下降定义为1秒用力呼气容积（FEV₁）的年下降率≥50 mL。患者分为快速下降组（n = 26）和非快速下降组（n = 31）。
快速下降组和非快速下降组在运动性低氧血症方面存在统计学显著差异（17例对8例，p = 0.003）。两组在年龄、吸烟状况、BODE指数和FEV₁方面未发现差异。多变量分析表明，运动性低氧血症是COPD患者快速下降的一个显著独立预测指标（相对风险，6.8；95%CI，1.8至25.4；p = 0.004）。
本研究支持运动性低氧血症是男性COPD患者肺功能快速下降的一个预测指标。
