中国全科医学 ›› 2021, Vol. 24 ›› Issue (10): 1294-1297.DOI: 10.12114/j.issn.1007-9572.2021.00.031

所属专题: 呼吸疾病文章合集 运动相关研究最新文章合集

• 专题研究 • 上一篇    下一篇

社区慢性阻塞性肺疾病患者运动能力及预后评估方法研究

李海燕1,杨汀2*,姚反修1,刘红3   

  1. 1.450052河南省郑州市,郑州大学第五附属医院全科医学科 2.100029北京市,中日友好医院呼吸中心/呼吸与危重症医学科 国家呼吸医学中心 中国医学科学院呼吸病学研究院 国家呼吸疾病临床医学研究中心 世界卫生组织戒烟与呼吸疾病预防合作中心 3.450003河南省郑州市,郑州大学第一附属医院呼吸与危重症医学科
    *通信作者:杨汀,主任医师,教授,博士生导师;E-mail:dyyangting@qq.com
  • 出版日期:2021-04-05 发布日期:2021-04-05
  • 基金资助:
    中国医学科学院慢性呼吸疾病防控体系研究(2019TX320005)

Exercise Capacity and Prognosis Evaluation Methods for Patients with Chronic Obstructive Pulmonary Disease in the Community 

LI Haiyan1,YANG Ting2*,YAO Fanxiu1,LIU Hong3   

  1. 1.Department of General Practice,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China
    2.Respiratory Center,Department of Respiratory and Critical Care Medicine,National Center for Respiratory Medicine,China-Japan Friendship Hospital,Institute of Respiratory Medicine,Chinese Academy of Medical Sciences/National Clinical Research Center for Respiratory Diseases/WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention,Beijing 100029,China
    3.Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,China
    *Corresponding author:YANG Ting,Chief physician,Professor,Doctoral supervisor;E-mail:dyyangting@qq.com
  • Published:2021-04-05 Online:2021-04-05

摘要: 背景 慢性阻塞性肺疾病(COPD)是老年患者的常见疾病,肌少症及运动能力下降是普遍存在的问题,运动能力和患者预后有一定的相关性,而对二者评估方法的研究较少。目的 探讨可以在社区评估COPD患者运动能力及预后的简便准确的方法。方法 纳入2018年1月—2019年12月中日友好医院100例COPD稳定期患者,探讨6 min步行试验距离(6MWD)、简易躯体能力测试试验(SPPB)及改良英国医学研究学会呼吸困难指数(mMRC)分级之间的关系。结果 6MWD与mMRC分级呈负相关(rs=-0.431,P=0.002),mMRC分级预测6MWD的受试者工作特征曲线下面积为0.749(P<0.001),当6MWD为483.5 m时,约登指数最大为0.426,是6MWD与mMRC分级的界值。SPPB与组内数据呈正相关(P<0.001),其中5次坐站测试(5STS)与SPPB相关性最高(rs=0.751)。6MWD与5STS具有相关性(rs=0.291,P=0.038)。结论 mMRC分级与5STS测试均可以成为基层评估COPD患者运动能力及预后的简便及较准确的方法,二者有一定的相关性。6MWD低于483.5 m时,呼吸困难对运动的限制较大,可以适时开展呼吸康复治疗。

关键词: 肺疾病, 慢性阻塞性;6 min步行试验;简易躯体能力测试试验;改良英国医学研究学会呼吸困难指数

Abstract: Background Elderly patients are more easily to be found with chronic obstructive pulmonary disease (COPD),as well as its associated sarcopenia and decreased exercise capacity. Exercise capacity has an association with the prognosis,but there is little research on the evaluation methods of the two. Objective To explore simple and accurate methods that can assess the exercise capacity and prognosis of patients with COPD in the community. Methods A total of 100 patients with stable COPD were recruited from China-Japan Friendship Hospital from January 2018 to December 2019. The relationships of six-minute walking distance(6MWD) with Short Physical Performance Battery(SPPB) score and modified British Medical Research Council(mMRC) classification were analyzed. Results The result of 6MWD increased with the decrease of mMRC score for classifying COPD (rs=-0.431,P=0.002). The AUC of mMRC classification for predicting 6MWD was 0.749 (P<0.001),and the maximum Youden index was 0.426 when 6MWD was 483.5 meters,which was determined as the cut-off threshold. The SPPB was positively correlated with the intragroup data(P<0.001),and its correlation with 5-repetition sit-to-stand(5STS)was the strongest(rs=0.751). Therefore,6MWD was correlated with 5STS(rs=0.291,P=0.038). Conclusion Both mMRC classification and 5STS test could be used as simple methods with relatively high accuracy for the assessment of exercise capacity and prognosis of patients with COPD in primary care,and they are partially correlated. When the 6MWD is less than 483.5 meters,dyspnea restricts movement greatly,and pulmonary rehabilitation can be carried out timely.

Key words: Pulmonary diseases, chronic obstructive;Six minutes walk test;Short physical performance battery;Modified British medical research council