| 王兴华,杨曙光,闫若男,于宁霞,洪赟晢,余学庆.六分钟步行试验在特发性肺纤维化患者疾病进展中的预测价值[J].中国康复,2024,39(10):604-610 |
| 六分钟步行试验在特发性肺纤维化患者疾病进展中的预测价值 |
| Predictive value of 6-minute walking test in disease progression of patients with idiopathic pulmonary fibrosis |
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| DOI：10.3870/zgkf.2024.10.006 |
| 中文关键词: 特发性肺纤维化 疾病进展 六分钟步行试验 血氧饱和度 |
| 英文关键词: idiopathic pulmonary fibrosis disease progression the 6-minute walk test blood oxygen saturation |
| 基金项目:国家自然科学基金项目（82174307）；河南省中医药科研专项（2022JDZX118） |
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| 中文摘要: |
| 目的：探讨六分钟步行试验（6MWT）在特发性肺纤维化（IPF）患者疾病进展中的预测价值。方法：选取215例IPF患者，对患者进行为期1年的随访，1年后根据是否出现疾病进展分为进展组132例、无进展组83例。采用Pearson相关分析法分析6MWT参数和肺功能参数的相关性，采用多因素Logistic回归分析筛选影响IPF疾病进展的危险因素，绘制IPF疾病进展的受试者特征曲线（ROC），采用ROC曲线分析预测疾病进展。结果：进展组六分钟步行距离（6MWD）、静息血氧饱和度（R-SPO2）、运动性血氧饱和度（E-SPO2）较无进展组低（P＜0.01），进展组出现运动性低氧血症的比率较无进展组高（P＜0.01）；进展组的用力肺活量（FVC）、FVC占预计值百分比（FVC%）、一氧化碳弥散量（DLCO）、肺活量（VC）较无进展组低（P＜0.01），进展组的一氧化碳弥散量占预计值百分比（DLCO%）较无进展组高（P＜0.01）；2组静息性低氧血症比率、第一秒用力呼气容积（FEV1）比较差异无统计学意义。6MWD、R-SPO2、E-SPO2与FVC、FVC%、DLCO、DLCO%、VC呈正相关（P＜0.05）。二元Logistic回归分析结果显示6MWD、E-SPO2、FVC%是IPF患者疾病进展的独立危险因素。6MWD截断值为398m，评估IPF患者疾病进展的ROC曲线下面积为0.779（95%CI：0.717-0.841），灵敏度为75%，特异度为70%；E-SPO2的截断值为92%，评估IPF疾病进展的ROC曲线下面积为0.716（95%CI：0.648-0.784），灵敏度为55%，特异度为78%。结论：IPF进展组患者6MWD、SPO2较无进展组显著降低，并与IPF患者疾病严重程度密切相关，6MWD、SPO2可作为评估IPF疾病进展的重要依据。 |
| 英文摘要: |
| Objective: To investigate the predictive value of 6-minute walking test(6MWT) in disease progression of patients with idiopathic pulmonary fibrosis (IPF). Methods: All 215 patients with IPF were selected. Patients were followed up for 1 year, and lung function and 6MWT parameters were collected at baseline and 1 year later. After 1 year of follow-up, patients were divided into a progressive group (132 cases) and a non-progressive group (83 cases) according to whether disease progression occurred. Pearson correlation analysis was used to analyze the correlation between 6MWT parameters and lung function parameters. Multivariate Logistic regression was used to analyze the risk factors affecting IPF disease progression. ROC curve of IPF disease progression was drawn, and cutoff value of disease progression was predicted by ROC curve analysis. Results: Compared with the non-progression group, the baseline 6MW distance (6MWD), R-SPO2 and E-SPO2 were lower, and the probability of resting and exercise hypoxemia was higher (P<0.01). 6MWD, R-SPO2 and E-SPO2 were positively correlated with FVC, FVC%, DLCO, DLCO% and VC (P<0.05). Binary Logistic regression analysis showed that 6MWD, E-SPO2 and FVC% were independent risk factors for disease progression in patients with IPF. The cut-off value of 6MWD was 398m, the area under ROC curve for assessing disease progression in IPF patients was 0.779 (95%CI: 0.717-0.841), the sensitivity was 75%, and the specificity was 70%. The cutoff value of E-SPO2 was 92%, the area un- der the ROC curve for assessing IPF disease progression was 0.716 (95%CI: 0.648-0.784), the sensitivity was 55%, and the specificity was 78%. Conclusion: Baseline 6MWD and blood oxygen saturation in patients with IPF progression were significantly lower than those in the non-progression group, and were closely correlated with disease severity in patients with IPF. 6MWD and SPO2 could be used as an important basis for the assessment of disease progression in IPF. |
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