Borak J, Chodosowska E, Matuszewski A, Zielinski J
Dept of Respiratory Medicine, Institute of TB and Lung Diseases, Warsaw, Poland.
Eur Respir J. 1998 Aug;12(2):370-3.
Exercise tolerance in chronic obstructive pulmonary disease (COPD) patients has been shown to be related to airway limitation and dyspnoea, but little is known about the effects of an emotional status on physical performance. We examined 49 COPD patients with a wide spectrum of airway limitation severity and hypoxaemia. Exercise tolerance was evaluated using the Six-minute Walking Distance Test (6MWD), dyspnoea at rest and on exercise was measured using the visual analogue scale, and the emotional status was evaluated using the battery of psychological tests. The average 6MWD (mean+/-SD) was 355+/-112 m. In the majority of patients a fall in arterial blood oxygen saturation (Sa,O2) on exercise of >3% was found. The mean dyspnoea score of 21+/-19 at rest increased to 66+/-19 on exercise. All subjects demonstrated an increased level of anxiety. The majority also demonstrated elevated emotional tension, and half of the study group showed signs of depression. Step-wise multiple regression analysis with results of 6MWD as dependent and other studied variables as independent variables showed that exercise tolerance depended mainly on airway limitation. The forced expiratory volume in one second (FEV1) explained 24% of the variance. The forced vital capacity added a further 10%, and arterial blood carbon dioxide tension contributed 7%. The dyspnoea level on exercise added only 0.9%. All four variables explained 42% of the variance. There was no correlation between 6MWD and any of the variables characterizing the emotional status. We conclude that the emotional status of chronic obstructive pulmonary disease patients is characterized by an increased level of psychological tension, anxiety and depression, but these do not affect exercise tolerance as assessed by the six-minute walking distance test.
慢性阻塞性肺疾病（COPD）患者的运动耐力已被证明与气道受限和呼吸困难有关，但关于情绪状态对身体表现的影响却知之甚少。我们对49例气道受限严重程度和低氧血症范围广泛的COPD患者进行了研究。使用六分钟步行距离测试（6MWD）评估运动耐力，使用视觉模拟量表测量静息和运动时的呼吸困难程度，并使用一系列心理测试评估情绪状态。平均6MWD（平均值±标准差）为355±112米。在大多数患者中，发现运动时动脉血氧饱和度（SaO₂）下降>3%。静息时平均呼吸困难评分为21±19，运动时增加到66±19。所有受试者均表现出焦虑水平升高。大多数人还表现出情绪紧张加剧，研究组中有一半表现出抑郁迹象。以6MWD结果为因变量、其他研究变量为自变量进行逐步多元回归分析表明，运动耐力主要取决于气道受限。一秒用力呼气量（FEV₁）解释了24%的方差。用力肺活量又增加了10%，动脉血二氧化碳分压贡献了7%。运动时的呼吸困难水平仅增加了0.9%。这四个变量共同解释了42%的方差。6MWD与任何表征情绪状态的变量之间均无相关性。我们得出结论，慢性阻塞性肺疾病患者的情绪状态表现为心理紧张、焦虑和抑郁水平升高，但这些并不影响通过六分钟步行距离测试评估的运动耐力。
