六分钟步行试验用于评估系统性硬化症患者的预后？

Six-minute walk test in or out in evaluation of systemic sclerosis patients?

作者信息

Vandecasteele Els, Thevissen Kristof, Melsens Karin, De Keyser Filip, De Pauw Michel, Deschepper Ellen, Decuman Saskia, Piette Yves, Brusselle Guy, Smith Vanessa

机构信息

Department of Cardiology, Ghent University Hospital, Belgium.

Department of Rheumatology, Ghent University Hospital, Belgium.

出版信息

Clin Exp Rheumatol. 2017 Sep-Oct;35 Suppl 106(4):122-129. Epub 2017 Feb 15.

PMID:28229829

Abstract

OBJECTIVES

Interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH) are the leading causes of death in systemic sclerosis (SSc) patients. Although the six-minute walk test (6MWT) is used for evaluating ILD and PAH in clinical practice, no data are available on six-minute walk distance (6MWD) and oxygen desaturation in SSc patients without ILD and PAH.

METHODS

Prospectively collected data of the 6MWTs at baseline and 6-month follow-up of 300 consecutive SSc patients, included in the Ghent University Hospital Systemic Sclerosis Unit between May 2006 and April 2015 were analysed.

RESULTS

The mean 6MWD of 165 SSc patients without ILD and PAH who performed a 6MWT at baseline or at the 6-month visit was 484±93m. Patients in the diffuse cutaneous (DcSSc) subgroup (435±94m) walked less than in the limited (LSSc) subgroup (499±91m, p=0.04) and tended to walk less than in the limited cutaneous (LcSSc) subgroup (483±92m, p=0.15). In 115 SSc patients without ILD and PAH who walked at both moments, there was no significant difference between the 6MWDs (mean difference -7.60m 95%CI [-19.93m; 4.73m], p=0.23) and the oxygen desaturation was not statistically different in 102 of them (mean difference 0.41% 95%CI [-0.49%; 1.31%], p=0.37).

CONCLUSIONS

In SSc without ILD and PAH, the 6MWD and oxygen desaturation is clinically stable over a 6 months period. The DcSSc subgroup walks less than the LSSc and the LcSSc subgroup.

摘要

目的

间质性肺病（ILD）和肺动脉高压（PAH）是系统性硬化症（SSc）患者的主要死亡原因。尽管六分钟步行试验（6MWT）在临床实践中用于评估ILD和PAH，但尚无关于无ILD和PAH的SSc患者六分钟步行距离（6MWD）和氧饱和度下降的数据。

方法

对2006年5月至2015年4月间根特大学医院系统性硬化症科连续纳入的300例SSc患者在基线和6个月随访时的6MWT前瞻性收集的数据进行分析。

结果

165例在基线或6个月随访时进行6MWT的无ILD和PAH的SSc患者的平均6MWD为484±93米。弥漫性皮肤型（DcSSc）亚组患者（435±94米）的步行距离短于局限性（LSSc）亚组（499±91米，p = 0.04），且倾向于短于局限性皮肤型（LcSSc）亚组（483±92米，p = 0.15）。在115例在两个时间点均进行步行的无ILD和PAH的SSc患者中，6MWD之间无显著差异（平均差异-7.60米，95%CI[-19.93米；4.73米]，p = 0.23），其中102例患者的氧饱和度下降无统计学差异（平均差异0.41%，95%CI[-0.49%；1.31%]，p = 0.37）。