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新冠病毒检测呈阳性患者的主两步运动负荷试验与六分钟步行试验的比较

Comparison of master two-step exercise stress test versus six-min walk test in patients tested positive for SARS-CoV-2.

作者信息

Kumar Ankit, Hegde Naveen, Kumaravel J, Mohindra Ritin, Soni Roop Kishor, Rathod Ramya, Kumar Mohan, Muthu Valliappan, Gamad Nanda, Patil Amol N, Sharma P L

机构信息

Department of Pharmacology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

出版信息

J Family Med Prim Care. 2022 Nov;11(11):7008-7014. doi: 10.4103/jfmpc.jfmpc_1111_22. Epub 2022 Dec 16.

Abstract

BACKGROUND AND AIM

There has been a lack of uniformity on how to triage coronavirus disease 2019 (COVID-19) patients visiting the emergency units of hospitals. Triage tools are themselves spreading the pandemic in hospital areas. The present study compared a master two-step (M2ST) exercise stress test versus a 6-min walk test (6MWT) in COVID-19-positive patients visiting the emergency unit of a hospital.

MATERIALS AND METHODS

Thirty-nine patients underwent 6MWT followed by M2ST, while another set of 38 patients underwent M2ST followed by 6MWT in this randomized, crossover, open-label, and noninferiority study. The exercise tests assessed the change from baseline in SpO, heart rate (HR), respiratory rate, blood pressure, exertion, and dyspnea on the modified-Borg scale.

RESULTS

Noninferiority was established for SpO ( < 0.05), systolic blood pressure (SBP; < 0.001), and diastolic blood pressure (DBP; < 0.05), but not for HR ( = 0.3) and respiratory rate ( = 0.6). The difference between the pretest and posttest (delta change) values for the parameters SpO, respiratory rate, HR, SBP, and DBP correlated significantly ( < 0.001) with Pearson correlation coefficient ( = 0.764, 0.783, 0.473, 0.838, and 0.783, respectively). The delta change values of modified-Borg scale for dyspnea ( = 0.291) and exertion ( = 0.208) were statistically insignificant between the two exercise tests. However, the correlation between the tests was statistically significant ( < 0.001).

CONCLUSION

M2ST, a timesaving, cost-effective, and easy to perform exercise stress test, has been identified as a reliable alternative for 6MWT.

摘要

背景与目的

对于前往医院急诊科的2019冠状病毒病(COVID-19)患者,在如何进行分诊方面缺乏统一标准。分诊工具本身正在医院区域传播这种大流行病。本研究比较了在一家医院急诊科就诊的COVID-19阳性患者中,主两步(M2ST)运动应激试验与6分钟步行试验(6MWT)。

材料与方法

在这项随机、交叉、开放标签且非劣效性研究中,39名患者先进行6MWT,然后进行M2ST,而另一组38名患者先进行M2ST,然后进行6MWT。运动试验评估了在改良Borg量表上,从基线开始的血氧饱和度(SpO)、心率(HR)、呼吸频率、血压、用力程度和呼吸困难的变化。

结果

在SpO(<0.05)、收缩压(SBP;<0.001)和舒张压(DBP;<0.05)方面确立了非劣效性,但在HR(=0.3)和呼吸频率(=0.6)方面未确立。SpO、呼吸频率、HR、SBP和DBP参数的测试前与测试后(差值变化)值之间的差异与Pearson相关系数显著相关(<0.001)(分别为=0.764、0.783、0.473、0.838和0.783)。在两项运动试验之间,改良Borg量表上呼吸困难(=0.291)和用力程度(=0.208)的差值变化值无统计学意义。然而,两项试验之间的相关性具有统计学意义(<0.001)。

结论

M2ST是一种省时、经济高效且易于实施的运动应激试验,已被确定为6MWT的可靠替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f702/10041178/36fe98575499/JFMPC-11-7008-g001.jpg

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