Saxena Puneet, Singh Itishree, Kumar Abhishek, Kartik S, Malik Virender, Tiwari Saurabh, Akhil K R, Pattanayak Somali, Velangi Vaibhavi G, Jain Harsh
Department of Pulmonary Medicine, Army Hospital Research and Referral, New Delhi, India.
Department of Rheumatology, Army Hospital Research and Referral, New Delhi, India.
Lung India. 2023 Sep-Oct;40(5):429-433. doi: 10.4103/lungindia.lungindia_165_23.
Forced vital capacity (FVC) and six-minute walk distance (6MWD) are robust markers in interstitial lung diseases (ILD) to assess severity and prognosis. It is unknown whether high-resolution computed tomography pattern has any independent effect on the exercise capacity in ILD. We compared six-minute walk test (6MWT) parameters between usual interstitial pneumonia (UIP) and non-UIP ILD after adjusting for FVC.
Data from a tertiary care ILD clinic were retrospectively analysed. Based on HRCT, patients were classified as UIP and non-UIP. 6MWT parameters and FVC were recorded for enrolled patients. 6MWD, distance-saturation product (DSP) and exertional desaturation were compared between UIP and non-UIP, using analysis of covariance (ANCOVA), with per cent predicted FVC as covariate. Patients were grouped as mild (≥70%), moderate (51%-69%) and severe (≤50%) based on FVC severity.
Out of 169 patients enrolled, only patients with all three data points: spirometry, 6MWT and HRCT were included in the analysis (n = 139). UIP group comprised 56 (40.3%), while non-UIP group had 83 (59.7%) patients. More females and lesser smokers were present in non-UIP group. Mean predicted FVC% was similar between the two HRCT groups (P = 0.611) and had a statistically significant, though very weak to weak correlation with 6MWT parameters {6MWD (r = 0.138); pred 6MWD% (r = 0.170); desaturation (r = -0.227); DSP index (r = 0.166)}. Analysis of covariance showed no statistically significant difference in the 6MWT parameters between UIP and non-UIP groups for similar FVC levels.
For a similar level of lung function, exercise capacity was similar for patients with UIP and non-UIP pattern ILD.
用力肺活量（FVC）和六分钟步行距离（6MWD）是间质性肺疾病（ILD）中评估严重程度和预后的可靠指标。高分辨率计算机断层扫描模式对ILD患者的运动能力是否有独立影响尚不清楚。我们在调整FVC后比较了普通型间质性肺炎（UIP）和非UIP型ILD患者的六分钟步行试验（6MWT）参数。
对一家三级医疗ILD诊所的数据进行回顾性分析。根据高分辨率CT，将患者分为UIP组和非UIP组。记录入选患者的6MWT参数和FVC。采用协方差分析（ANCOVA），以预测FVC百分比作为协变量，比较UIP组和非UIP组之间的6MWD、距离-饱和度乘积（DSP）和运动性低氧饱和度。根据FVC严重程度将患者分为轻度（≥70%）、中度（51%-69%）和重度（≤50%）。
在入选的169例患者中，分析仅纳入了具有肺量计、6MWT和高分辨率CT这三个数据点的患者（n = 139）。UIP组有56例（40.3%），而非UIP组有83例（59.7%）患者。非UIP组女性更多，吸烟者更少。两个高分辨率CT组之间的平均预测FVC%相似（P = 0.611），且与6MWT参数{6MWD（r = 0.138）；预测6MWD%（r = 0.170）；低氧饱和度（r = -0.227）；DSP指数（r = 0.166）}有统计学意义的相关性，尽管相关性非常弱至较弱。协方差分析显示，对于相似的FVC水平，UIP组和非UIP组之间的6MWT参数无统计学显著差异。
对于相似的肺功能水平，UIP型和非UIP型ILD患者的运动能力相似。
