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4 米步行速度与慢性阻塞性肺疾病临床指标的相关性。

Correlation of 4-meter gait speed with clinical indicators of chronic obstructive pulmonary disease.

机构信息

Department of Respiratory Medicine, National Hospital Organization Fukuokahigashi Medical Center, 1-1-1 Chidori, Koga, Fukuoka, 811-3195, Japan.

Department of Respiratory Medicine, National Hospital Organization Fukuokahigashi Medical Center, 1-1-1 Chidori, Koga, Fukuoka, 811-3195, Japan.

出版信息

Respir Investig. 2021 Jul;59(4):505-512. doi: 10.1016/j.resinv.2021.03.008. Epub 2021 Apr 23.

Abstract

BACKGROUND

Measuring daily physical activity and exercise capacity is recommended in the routine care of patients with chronic obstructive pulmonary disease (COPD). The 4-m gait speed (4mGS) is simple and effective in stratifying patients according to exercise performance, dyspnea, health status, and prognosis. We assessed the reliability of the 4mGS as a clinical marker by examining its association with established clinical indicators among hospitalized patients with COPD.

METHODS

This retrospective study included 78 patients hospitalized with COPD (mean age: 76.3 ± 0.9 years; males, n = 69) between January 2016 and June 2018 who were assessed using the 4mGS and divided into slow (<0.8 m/s) and normal (≥0.8 m/s) 4mGS groups. Clinical characteristics were compared, including death during the observation period, time to first exacerbation, and long-term oxygen therapy requirement.

RESULTS

There were strong relationships between 4mGS performance, the 6-min walk test (R = 0.70; p < 0.0001), and the modified Medical Research Council dyspnea scale (R = 0.68; p < 0.0001) among the 78 patients. The slow 4mGS group had a higher frequency of death during the observation period (p = 0.0095) and a greater requirement for long-term oxygen therapy (p = 0.0063). The 4mGS correlated with inspiratory capacity (IC) and IC/total lung capacity ratios, which are respiratory failure indicators.

CONCLUSIONS

The 4mGS is a simple and easy method of assessing the physical condition as well as estimating the prognosis of patients with COPD, and may serve as a useful marker in home medical treatment or clinical settings.

摘要

背景

在慢性阻塞性肺疾病(COPD)患者的常规护理中,建议测量日常体力活动和运动能力。4 米步行速度(4mGS)可根据运动表现、呼吸困难、健康状况和预后对患者进行简单有效的分层。我们通过检查其与 COPD 住院患者的既定临床指标的相关性,评估了 4mGS 作为临床标志物的可靠性。

方法

这项回顾性研究纳入了 2016 年 1 月至 2018 年 6 月期间因 COPD 住院的 78 例患者(平均年龄:76.3±0.9 岁;男性,n=69),评估了 4mGS,并将其分为步行速度较慢(<0.8 m/s)和正常(≥0.8 m/s)4mGS 组。比较了临床特征,包括观察期间的死亡、首次加重时间和长期氧疗需求。

结果

78 例患者中,4mGS 表现与 6 分钟步行试验(R=0.70;p<0.0001)和改良医学研究委员会呼吸困难量表(R=0.68;p<0.0001)之间存在较强的关系。4mGS 较慢的患者在观察期间的死亡率更高(p=0.0095),长期氧疗需求更大(p=0.0063)。4mGS 与吸气量(IC)和 IC/总肺容量比相关,这些是呼吸衰竭的指标。

结论

4mGS 是一种简单易用的评估 COPD 患者身体状况和估计预后的方法,可能成为家庭医疗或临床环境中的有用标志物。

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