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Six-Minute Walking Test in Patients with Chronic Obstructive Pulmonary Disease

慢性阻塞性肺疾病病患的六分鐘步行試驗

摘要


背景:運動測驗已被廣泛的運用於慢性心肺疾病病患的臨床評估。本篇報告在研究慢性阻塞性肺疾病病患在進行六分鐘步行試驗時,其肺功能、喘的程度、氧氣飽和度之間的相互關係。 方法:60位慢性阻塞性肺疾病病患(48位男性)接受六分鐘走路測驗,每位病患都接受肺功能之檢查,同時在進行步行測驗時,每位病患之氧氣飽和度、喘之嚴重度及步行距離都被記錄下來。 結果:病患各項變數的平均值及標準差如後述;一秒內用力呼氣量:l.0462公升(標準差:0.457),用力肺活量:18.6公升(0.58),跑步距離:391公尺(126.7),氧氣飽和度下降程度:7.57%(4.42),年齡69.18(11.63),身體質量指數:23.29(5.13),尖端峰呼氣流速:每分鐘168.6公升(83.26),六分鐘跑步距離(r值)與尖烽呼氣流速有相關(r值:0.26),與一秒內用力呼氣量有相關(0.273),但與跑步時的氧氣飽和度下降程度、喘氣指數及身體質量指數沒有相關。而氧氣飽和度下降之程度和尖峰呼氣流速(-0.315),一秒內用力呼氣量(-0.349),用力肺活量(-0.312)及身體質量指數(-0.294)有相關,但與喘氣指數沒有相關。 結論:此項研究發現慢性阻塞性肺疾病病患之運動功能和其本身之肺功能息息相關而和喘氣的嚴重度及氧氣飽和相關性不強。此外,在進行步行測驗時,病患是否會發生氣飽和度下降,無法由較主觀之測量,如喘氣指數來預測,其原因可能與心理因素,呼吸功能肌之協調及動態性過度充氣有關。

並列摘要


Background: Traditionally, the objective evaluation of the patient with COPD has relied to a great extent on spirometry, which is considered an indicator of pulmonary function. However, pulmonary function alone is not a valid gauge of functional capacity. This is reflected by the fact that the perception of breathlessness varies considerably between patients with similar degrees of airflow limitation. In this study, the relative contribution of lung function, dyspnea, and degree of desaturation in patients with chronic obstructive pulmonary disease (COPD), to their performance in a walking distance test was investigated. Methods: The 6-minute walking test was performed with 60 patients with COPD (48 males and 12 females). Spirometry was measured. Arterial oxygen desaturation during the walking test was monitored by a portable pulse oximeter. The level of dyspnea was assessed by means of a modified Borg scale. Results: The mean and standard deviation of the patients' variables were as follows: forced vital capacity in 1 second (FEV1), 1.0462±0.457 liters; forced vital capacity (FVC), 1.86±0.58 liters; walking distance, 391±126.7 meters; degree of desaturation, 7.57±4.42%; age, 69.18±11.63 years; body mass index, 23.29±5.13; and peak expiratory flow, 168.6±83.26 liters per minute. The 6-minute walking distance was correlated (r value) with peak expiratory flow (PEF:0.26), forced expiratory volume in 1 second (FEV1:0.258), forced vital capacity (FVC:0.273), and age, but not with the degree of desaturation during the walk, with the Borg scale, or the body mass index (BMI). The degree of desaturation during the walk was correlated with PEF (-0.315), FEV1 (-0.349), FVC (-0.312), and BMI (-0.294), but not with the Borg scale. Conclusions: The results show that exercise capacity in patients with COPD is more related to lung function than to level of dyspnea and degree of desaturation. In addition, the degree of desaturation during the walk could not be predicted by subjective measurements, such as the Borg scale. It is speculated that psychosocial factors, ineffective inspiratory muscle response, and the development of dynamic lung hyperinflation may play a role in these discrepancies. In addition, the 6-minut walking test is a useful tool to assess functional capacity in patients with COPD.

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