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肺结核后肺部疾病成人患者运动耗氧量、肺功能、影像表现及生活质量之间的相关性

Correlations between exercise oxygen consumption, lung function, image findings, and quality of life in adults with post-tuberculosis lung disease.

作者信息

da Silva Marcela Pinto Venâncio Lourenço, da Silva Pinto Paulo Victor Leandro, Fonseca Iasmim Maria Pereira Pinto, de Lima Lucas Silva, Carneiro Alícia Sales, Costa Walter, Santos Ana Paula, Lopes Agnaldo José

机构信息

Rehabilitation Sciences Postgraduate Programme, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, Brazil.

Postgraduate Programme in Medical Sciences, School of Medical Sciences, Universidade do Estado do Rio de Janeiro (UERJ), Brazil.

出版信息

Chron Respir Dis. 2025 Jan-Dec;22:14799731251345492. doi: 10.1177/14799731251345492. Epub 2025 May 22.

Abstract

The aim of this study is to evaluate the correlations of peak oxygen uptake (VO2peak) with lung mechanics, radiographic abnormalities, and quality of life (QoL) in adults with post-tuberculosis lung disease (PTLD). This is a cross-sectional study in which 60 adults with PTLD underwent a cardiopulmonary exercise test (CPET). Additionally, the following assessments were performed: spirometry, impulse oscillometry (IOS), chest X-ray (CXR), and QoL using the WHOQOL-BREF. The mean peak oxygen uptake (VO) was 16.1 ± 6.8 ml/kg/min. There were positive correlations between VO and several parameters, including height, physical-WHOQOL-BREF, and forced vital capacity (FVC). There were negative correlations between VO and several parameters, including age, heterogeneity of resistance between 5 and 20 Hz, frequency response (Fres), and reactance-area. In IOS, patients with small airway disease (SAD) had a lower VO. Regarding CXR, only cavitation and nodular opacities were associated with a lower VO. In multivariate analysis, FVC, age, male sex, and Fres explained 65.2% of the variability in VO. In conclusion, there is a relationship between VO and lung mechanics in patients with PTLD. In these patients, IOS is able to detect more pulmonary mechanical alterations than spirometry, including those reflecting SAD. Thus, the use of both CPET and IOS may aid in the monitoring of patients with PTLD.

摘要

本研究旨在评估肺结核后肺部疾病(PTLD)成人患者的最大摄氧量(VO2peak)与肺力学、影像学异常及生活质量(QoL)之间的相关性。这是一项横断面研究,60例PTLD成人患者接受了心肺运动试验(CPET)。此外,还进行了以下评估:肺量计检查、脉冲振荡法(IOS)、胸部X线(CXR)检查以及使用世界卫生组织生活质量简表(WHOQOL-BREF)进行生活质量评估。平均最大摄氧量(VO)为16.1±6.8 ml/kg/min。VO与多个参数之间存在正相关,包括身高、WHOQOL-BREF生理领域得分和用力肺活量(FVC)。VO与多个参数之间存在负相关,包括年龄、5至20 Hz之间的阻力不均匀性、频率响应(Fres)和电抗面积。在IOS检查中,小气道疾病(SAD)患者的VO较低。关于CXR,只有空洞和结节状阴影与较低的VO相关。在多变量分析中,FVC、年龄、男性性别和Fres解释了VO变异性的65.2%。总之,PTLD患者的VO与肺力学之间存在关联。在这些患者中,IOS比肺量计检查能够检测到更多的肺力学改变,包括反映SAD的改变。因此,CPET和IOS联合使用可能有助于PTLD患者的监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef05/12099090/8c19cd9b4935/10.1177_14799731251345492-fig1.jpg

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