Bell Martin, Fotheringham Iain, Punekar Yogesh Suresh, Riley John H, Cockle Sarah, Singh Sally J
Value Demonstration Practice, Oxford PharmaGenesis Ltd, Oxford, United Kingdom.
Value Evidence and Outcomes, GlaxoSmithKline, Brentford, United Kingdon.
Chronic Obstr Pulm Dis. 2015 Jul 8;2(4):321-342. doi: 10.15326/jcopdf.2.4.2014.0157.
Typical symptoms of chronic obstructive pulmonary disease (COPD) include breathlessness and reduced exercise capacity. Several laboratory- and field-based exercise tests are used to assess the exercise capacity of patients with COPD. It is unclear whether these exercise tests reflect the spirometric measures recommended for diagnosis of COPD. We therefore aimed to systematically assess the correlation between these exercise tests and common measures of lung function. A search of Embase™, MEDLINE and The Cochrane Library identified primary publications in English that reported data on the correlations (Pearson's or Spearman's rho) between the outcomes of exercise tests and the physiological measures of interest: forced expiratory volume in 1 second (FEV), forced vital capacity, inspiratory capacity and arterial oxygen saturation. We included studies reporting on the following exercise tests: 6- and 12-minute walk tests (6MWT and 12 MWT), incremental and endurance shuttle walk tests, incremental and endurance cycle ergometer tests, and treadmill tests. Of 1781 articles screened, 45 were ultimately deemed eligible for inclusion in this review. The most commonly reported lung function variable was FEV (reported by 39 studies); the most commonly reported exercise test was the 6-minute walk test (reported by 24 studies). FEV appears to correlate moderately-to-strongly with 6MWT and 12MWT; and moderately-to-very strongly with incremental cycle ergometer tests (ICET); evidence for other exercise tests was limited. There is evidence that 6MWT, 12MWT and ICET correlate with FEV to some degree; - evidence for associations of other exercise tests with measures of lung function in patients with COPD is limited. Clinicians must consider this when deciding to use these tests. Further comparisons of these tests must be made in order to assess which physiological and hemodynamic characteristics they reflect in patients with COPD.
慢性阻塞性肺疾病（COPD）的典型症状包括呼吸急促和运动能力下降。有几种基于实验室和现场的运动测试用于评估COPD患者的运动能力。目前尚不清楚这些运动测试是否反映了推荐用于诊断COPD的肺量计测量结果。因此，我们旨在系统评估这些运动测试与常见肺功能指标之间的相关性。检索Embase™、MEDLINE和Cochrane图书馆，确定了以英文发表的原始文献，这些文献报告了运动测试结果与感兴趣的生理指标之间的相关性（Pearson相关系数或Spearman秩相关系数）：1秒用力呼气量（FEV）、用力肺活量、吸气量和动脉血氧饱和度。我们纳入了报告以下运动测试的研究：6分钟和12分钟步行测试（6MWT和12MWT）、递增和耐力穿梭步行测试、递增和耐力功率自行车测试以及跑步机测试。在筛选的1781篇文章中，最终有45篇被认为符合纳入本综述的标准。最常报告的肺功能变量是FEV（39项研究报告）；最常报告的运动测试是6分钟步行测试（24项研究报告）。FEV似乎与6MWT和12MWT呈中度至强相关；与递增功率自行车测试（ICET）呈中度至非常强相关；其他运动测试的证据有限。有证据表明6MWT、12MWT和ICET在一定程度上与FEV相关；COPD患者中其他运动测试与肺功能指标关联的证据有限。临床医生在决定使用这些测试时必须考虑这一点。必须对这些测试进行进一步比较，以评估它们在COPD患者中反映的生理和血流动力学特征。
