静息性恶性通货膨胀预测慢性阻塞性肺疾病患者穿梭步行距离的增加。

IF 2.1 4区 医学 Q3 RESPIRATORY SYSTEM
Meera Srinivasan, David Touma, Kaj E C Blokland, Katrina O Tonga, David G Chapman, Gregory G King
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引用次数: 0

摘要

原理:增量穿梭行走试验(ISWT)与COPD患者的峰值摄氧量密切相关,并与死亡率、治疗反应和再入院等重要结果相关。尽管如此,关于慢性阻塞性肺病中ISWD距离的生理决定因素的数据有限。方法:在这项探索性、前瞻性观察性研究中,对确诊的COPD患者进行肺活量测定、肺容量、扩散容量(DLCO)和振荡测定。然后,患者完成了两次ISWT,并获得了最佳测试结果,通过距离步行测量。通过BORG评分评估ISWD和呼吸困难的决定因素。结果:纳入25例COPD患者,平均(SD)年龄71(8.82)岁,女性48%,平均(SD) FEV1 Z-score -2.54(0.83)。中位(IQR) ISWD为350(210-440)米(平均(SD) 66.4(27.9)%预测距离)。大多数患者(85%)由于无法维持步行速度而停止,预测次最大平均心率为77.3 (10.1)%,BORG呼吸困难评分为“严重”(中位数5/10 (IQR 4-5.5))。吸气量与TLC比(IC/TLC)与ISWD密切相关,即使校正了年龄和身高(rs = 0.59 p = 0.02)。振荡电抗(Xrs5)和DLCO也与ISWD相关。没有呼吸困难的振荡或呼吸量预测指标。结论:通过IC/TLC测量的静息过度充气可以预测亚极大呼吸困难下的ISWD,提示过度充气可能不是限制运动表现的机制,而是反映COPD的整体损害。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Resting Hyperinflation Predicts Incremental Shuttle Walk Distance in Chronic Obstructive Pulmonary Disease.

Rationale: The incremental shuttle walk test (ISWT) correlates closely with peak oxygen uptake in COPD and relates to important outcomes such as mortality, response to treatment and hospital readmission. Despite this, there is limited data on the physiological determinants of ISWT distance (ISWD) in COPD. Methods: In this exploratory, prospective observational study, spirometry, lung volumes, diffusion capacity (DLCO) and oscillometry were performed in patients with confirmed COPD. Patients then completed two ISWT with the results of the best test, measured by distanced walked taken. The determinants of ISWD and dyspnoea measured by BORG score were evaluated. Results: 25 COPD patients, mean (SD) age 71 (8.82) years, 48% female with a mean (SD) FEV1 Z-score -2.54 (0.83) were recruited. Median (IQR) ISWD was 350 (210-440) metres (mean (SD) 66.4 (27.9)% predicted distance). Most patients (85%) stopped due to inability to maintain walking speed with submaximal mean heart rate of 77.3 (10.1)% predicted and BORG dyspnoea score of 'severe' (median 5/10 (IQR 4-5.5)). Inspiratory capacity to TLC ratio (IC/TLC) correlated strongly with ISWD, even when corrected for age and height (rs = 0.59 p = 0.02). Oscillatory reactance (Xrs5) and DLCO were also correlated with ISWD. There were no oscillometric or spirometric predictors of dyspnoea. Conclusion: Resting hyperinflation measured by IC/TLC, predicted ISWD despite submaximal dyspnoea, suggesting that hyperinflation may not be the mechanism that limits exercise performance, but rather reflects overall impairment in COPD.

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来源期刊
CiteScore
4.40
自引率
0.00%
发文量
38
审稿时长
6-12 weeks
期刊介绍: From pathophysiology and cell biology to pharmacology and psychosocial impact, COPD: Journal Of Chronic Obstructive Pulmonary Disease publishes a wide range of original research, reviews, case studies, and conference proceedings to promote advances in the pathophysiology, diagnosis, management, and control of lung and airway disease and inflammation - providing a unique forum for the discussion, design, and evaluation of more efficient and effective strategies in patient care.
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