6分钟步行测试在稳定期成年支气管扩张患者中的应用:与临床指标相关性及影响因素

发布时间：2018-06-23 11:47

本文选题：支气管扩张 + 分钟步行试验　；参考：《中国实用内科杂志》2014年S1期

【摘要】：目的通过对不同临床指标进行分层比较,阐明稳定期支气管扩张患者6分钟步行距离(6MWD)的特征,探讨6MWD下降的主要危险因素。方法纳入141例支气管扩张患者[年龄(44.3±13.9)岁,87例为女性]。评估人口学、影像学、用力肺活量、弥散功能、病因学、痰细菌谱、改良医学研究理事会呼吸困难评分(MMRC)以及生活质量。探讨各临床指标与6MWD的相关性。构建Logistic回归模型以寻找6MWD下降的危险因素。结果 4个或以上支扩受累肺叶、HRCT总分至少为7分、囊状支扩、双侧支扩、弥散功能下降、MMRC评分较高、SGRQ总分及各维度评分增高均与低6MWD有关(P0.05)。6MWD与FVC pred%(r=0.253,P0.01),FEV1 pred%(r=0.227,P0.01)和DLCO pred%(r=0.175,P=0.05)正相关,与年龄(r=-0.379,P0.01)、支扩受累肺叶(r=-0.206,P=0.02)、HRCT总分(r=-0.242,P0.01)、SGRQ总分及各维度评分呈负相关(P0.01)。6MWD下降的风险因素包括较小年龄(OR=7.60,95%CI:3.63-15.91,P0.01)以及较高MMRC评分(OR=2.10,95%CI:1.19-3.70,P=0.11)。未发现6分钟步行试验的不良事件。结论 6分钟步行试验在支气管扩张患者中耐受性良好。6MWD与临床指标相关性较弱。年龄较小及较高的MMRC评分均为低6MWD的危险因素。
[Abstract]:Objective to elucidate the characteristics of 6-minute walking distance (6MWD) in patients with stable bronchiectasis by stratified comparison of different clinical indexes, and to explore the main risk factors for the decrease of 6MWD. Methods 141 patients with bronchiectasis were enrolled [age: (44.3 卤13.9) years: 87 women]. To evaluate demography, imaging, forced vital capacity, diffusion function, etiology, sputum bacterial spectrum, improved Medical Research Council Respiratory Disorders scale (MMRC), and quality of Life (QOL). To explore the correlation between clinical indexes and 6 MWD. Logistic regression model was established to find out the risk factors of 6 MWD decline. Results the total score of HRCT in 4 or more bronchiectasis was at least 7, cystic branch dilatation, bilateral bronchiectasis, decreased diffusion function, higher SGRQ total score and higher scores in each dimension were positively correlated with lower 6MWD scores (P0.05) .6MWD and FVC pred% (r0.253P0.01), FEV1 pred% (rna 0.227p 0.01) and DLCO pred% (rlCO 0.175P0. 05). The risk factors associated with the decrease of SGRQ and the scores of SGRQ (P 0.01) and the total score of SGRQ (P 0.01), the decrease of SGRQ score (P 0.01) and the higher score of MMRC (OR2.10 ~ 95CIU 1.19-3.70P0.11) were negatively correlated with the age (r = -0.379p 0.01), the total score of HRCT (r = 0.206n / 0.02) and the total score of SGRQ (r = 0.242P 0.01) and the decrease of the score of SGRQ by dimension (P 0.01), including the lower age (OR 7.6095 CI: 3.63-15.91P0.01) and the higher score of MMRC (OR2.10CIO 1.19-3.70P0.11). No adverse events were found in the 6-minute walking test. Conclusion the 6-minute walking test has a weak correlation with clinical parameters in patients with bronchiectasis. Younger and higher MMRC scores were risk factors for lower 6 MWD.
【作者单位】：广州医科大学附属第一医院广州呼吸疾病研究所(呼吸疾病国家重点实验室呼吸疾病国家临床研究中心);
【分类号】：R562.22

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