CHU Lille, Service de Pneumologie et Immuno-Allergologie, Centre de Compétence des Maladies Pulmonaires Rares, F-59000 Lille, France University of Lille, F-59000 Lille, France.
University of Lille, F-59000 Lille, France CHU Lille, EA 2694, Santé Publique: Epidémiologie et Qualité des Soins, Unité de Biostatistiques, F-59000 Lille, France.
Ther Adv Respir Dis. 2018 Jan-Dec;12:1753466618793028. doi: 10.1177/1753466618793028.
Although the 6-min walk test (6MWT) is the gold standard for assessing exercise-induced impairment of gas exchange, it cannot easily be performed in a clinical office environment. The aim of this study was to compare the 1-min sit-to-stand test (1STST) with the 6MWT for the ability to assess exercise-induced oxygen desaturation in patients with interstitial lung diseases (ILDs).
A total of 107 patients were enrolled and classified into three groups: sarcoidosis, fibrotic idiopathic interstitial pneumonia (f-IIP), and other forms of ILD. The 6MWT and 1STST were performed on the same day, and pulmonary function tests, pulse oxygen saturation (SpO), and dyspnea and fatigue (modified Borg scale) were assessed. SpO desaturation was evaluated by intraclass correlation coefficient (ICC), Bland-Altman analysis, and kappa (κ) coefficient in the whole population and the patient subgroups.
The SpO nadir during the 1STST and 6MWT showed good consistency [mean ± standard deviation: 92.5% ± 5% and 90% ± 7%, respectively; ICC 0.77, 95% confidence interval (CI) 0.71-0.83] and correlated strongly ( r = 0.9, p < 0.0001). The frequency of patients with oxygen desaturation ⩾4% was also consistent for the two exercise tests ( κ = 0.68, 95% CI 0.54-0.82). The number of repetitions in the 1STST correlated with the 6MWT distance ( r = 0.5, p < 0.0001), but the dyspnea scores were higher during the 1STST than the 6MWT ( p < 0.0001). These findings did not differ for the three patient subgroups.
The 1STST can measure exercise-induced desaturation in ILD patients and could be used as an alternative test to the 6MWT in office practice.
虽然 6 分钟步行试验(6MWT)是评估运动引起的气体交换受损的金标准,但它不能在临床办公环境中轻松进行。本研究的目的是比较 1 分钟坐站试验(1STST)和 6MWT 在评估间质性肺疾病(ILDs)患者运动引起的氧饱和度下降的能力。
共纳入 107 例患者,并分为三组:结节病、纤维化特发性间质性肺炎(f-IIP)和其他形式的 ILD。当天进行 6MWT 和 1STST,并进行肺功能测试、脉搏血氧饱和度(SpO)和呼吸困难和疲劳(改良 Borg 量表)评估。在整个人群和患者亚组中,通过组内相关系数(ICC)、Bland-Altman 分析和kappa(κ)系数评估 SpO 饱和度下降。
1STST 和 6MWT 期间的 SpO 最低值显示出良好的一致性[平均值±标准差:92.5%±5%和 90%±7%;ICC 0.77,95%置信区间(CI)0.71-0.83],且相关性很强(r=0.9,p<0.0001)。两种运动试验中出现氧饱和度下降≥4%的患者频率也一致(κ=0.68,95%CI 0.54-0.82)。1STST 中的重复次数与 6MWT 距离相关(r=0.5,p<0.0001),但 1STST 期间的呼吸困难评分高于 6MWT(p<0.0001)。这些发现在三个患者亚组中没有差异。
1STST 可测量 ILD 患者运动引起的缺氧,可替代 6MWT 在办公实践中使用。