Wibmer Thomas, Rüdiger Stefan, Kropf-Sanchen Cornelia, Stoiber Kathrin M, Rottbauer Wolfgang, Schumann Christian
Department of Internal Medicine II, University Hospital of Ulm, Ulm, Germany.
Respir Care. 2014 Nov;59(11):1687-95. doi: 10.4187/respcare.03082. Epub 2014 Sep 23.
There is growing evidence that exercise-induced variation in lung volumes is an important source of ventilatory limitation and is linked to exercise intolerance in COPD. The aim of this study was to compare the correlations of walk distance and lung volumes measured before and after a 6-min walk test (6MWT) in subjects with COPD.
Forty-five subjects with stable COPD (mean pre-bronchodilator FEV1: 47 ± 18% predicted) underwent a 6MWT. Body plethysmography was performed immediately pre- and post-6MWT.
Correlations were generally stronger between 6-min walk distance and post-6MWT lung volumes than between 6-min walk distance and pre-6MWT lung volumes, except for FEV1. These differences in Pearson correlation coefficients were significant for residual volume expressed as percent of total lung capacity (-0.67 vs -0.58, P = .043), percent of predicted residual volume expressed as percent of total lung capacity (-0.68 vs -0.59, P = .026), inspiratory vital capacity (0.65 vs 0.54, P = .019), percent of predicted inspiratory vital capacity (0.49 vs 0.38, P = .037), and percent of predicted functional residual capacity (-0.62 vs -0.47, P = .023).
In subjects with stable COPD, lung volumes measured immediately after 6MWT are more closely related to exercise limitation than baseline lung volumes measured before 6MWT, except for FEV1. Therefore, pulmonary function testing immediately after exercise should be included in future studies on COPD for the assessment of exercise-induced ventilatory constraints to physical performance that cannot be adequately assessed from baseline pulmonary function testing at rest.
越来越多的证据表明,运动引起的肺容积变化是通气受限的重要来源,并且与慢性阻塞性肺疾病(COPD)患者的运动不耐受有关。本研究的目的是比较COPD患者在6分钟步行试验(6MWT)前后测量的步行距离与肺容积之间的相关性。
45例稳定期COPD患者(支气管扩张剂使用前FEV1平均预计值为47±18%)接受了6MWT。在6MWT前和后立即进行体容积描记法检查。
除FEV1外,6分钟步行距离与6MWT后肺容积之间的相关性通常比6分钟步行距离与6MWT前肺容积之间的相关性更强。这些Pearson相关系数的差异在以肺总量百分比表示的残气量(-0.67对-0.58,P = 0.043)、以肺总量百分比表示的预计残气量百分比(-0.68对-0.59,P = 0.026)、吸气肺活量(0.65对0.54,P = 0.019)、预计吸气肺活量百分比(0.49对0.38,P = 0.037)以及预计功能残气量百分比(-0.62对-0.47,P = 0.023)方面具有统计学意义。
在稳定期COPD患者中,除FEV1外,6MWT后立即测量的肺容积与运动受限的关系比6MWT前测量的基线肺容积更密切。因此,在未来关于COPD的研究中,应包括运动后立即进行的肺功能测试,以评估运动引起的通气限制对身体表现的影响,而这无法通过静息时的基线肺功能测试进行充分评估。