COPD患者6MWT下指脉氧特点及运动耐力相关因素分析
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1.南京医科大学第一附属医院呼吸与危重症学科,江苏 南京 210029 ; 2.江苏大学附属医院呼吸与危重症医学科,江苏镇江 212050 ; 3.常州市妇幼保健院呼吸与危重症医学科,江苏 常州 213023

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R563

基金项目:

国家重点研发计划(2018YFC1311900);呼吸系统疾病临床研究大数据与生物样本库平台


The characteristics and correlative factors of pulse oxygen saturation and exercise tolerance of COPD patients in 6MWT
Author:
Affiliation:

1.Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029 ; 2.Department of Respiratory and Critical Care Medicine,the Affiliated Hospital of Jiangsu University,Zhenjiang 212050 ; 3.Department of Respiratory and Critical Care Medicine,Changzhou Maternal and Child HealthHospital,Changzhou 213023 ,China

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    摘要:

    目的:研究慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期患者在6 min步行试验(6-minute walk test,6MWT)下脉搏血氧饱和度(pulse oxygen saturation,SpO2)和运动耐力的特点及相关因素,为COPD患者提供简便有效的客观评估方法。方法:纳入COPD稳定期患者58例和对照组患者21例,收集一般资料、改良版英国医学研究委员会呼吸困难问卷(modified medical research council dyspnoea scale,mMRC)评分、COPD自我评估测试(COPD assessment test,CAT)评分、 肺功能参数(如FEV1%Pred、FVC%Pred、DLCO%Pred、DLCO/VA%Pred)和6MWT相关参数,分析SpO2和运动耐力指标的组间差异及其与COPD常用评估指标的相关性。结果:COPD患者在6MWT出现运动SpO2下降,表现为运动性低氧(exercise-induced de- saturation,EID),最低SpO2( SpO2min)和平均SpO2( SpO2mean)下降,运动SpO2低于88%、90%、92%的时间百分比(T88、T90、T92)和低氧面积(desaturation area,DA)增加;6 min 步行距离占预计值百分比(6MWD%Pred)和低氧距离比(desaturation distance ratio, DDR)在组间有差异;SpO2mean、DA、DDR、6MWD%Pred 均分别与mMRC评分、FEV1%Pred、FVC%Pred、静息SpO2( SpO2rest)相关, DDR还与DLCO%Pred、DLCO/VA%Pred相关,但是,多因素线性回归分析显示只有mMRC评分、DLCO%Pred和SpO2rest与DDR独立相关。结论:稳定期COPD患者6MWT同步持续脉搏指脉氧检测,其检测参数SpO2mean、DA、DDR和6MWD%Pred能有效反映 COPD患者肺功能和症状,提示该评估方法有效,有助于COPD患者的评估和管理。

    Abstract:

    Objective:To study the characteristics and correlative factors of pulse oxygen saturation(SpO2)and exercise tolerance during the 6-min walk test(6MWT)in the stable chronic obstructive pulmonary disease(COPD)patients,aiming to provide a simple and effective objective assessment method for COPD patients. Methods:A total of 58 stable COPD patients and 21 control subjects were enrolled. General data,modified Medical Research Council dyspnoea scale(mMRC)score,COPD assessment test(CAT)score, pulmonary function parameters(such as FEV1%Pred,FVC%Pred,DLCO%Pred,DLCO/VA%Pred),and 6MWT-related parameters were collected. The study analyzed the differences in SpO2 and exercise tolerance indicators between groups,and their correlation with commonly used COPD assessment indicators. Results:COPD patients exhibited a decline in exercise SpO2 during the 6MWT, characterized by the occurrence of exercise-induced desaturation(EID),a decline in minimum SpO2(SpO2min)and mean SpO2(SpO2mean), an increase in the percentage of time with SpO2 below 88%,90%,and 92%(T88,T90,T92)and desaturation area(DA). There were differences in the 6 - minute walk distance(6 MWD)as a percentage of the predicted value(6MWD% Pred)and the desaturation distance ratio(DDR)between the two groups. SpO2mean,DA,DDR and 6MWD%Pred were correlated with mMRC scores,FEV1%Pred, FVC%Pred,and resting SpO2(SpO2rest). DDR was also correlated with DLCO%Pred and DLCO/VA%Pred. However,multivariable linear regression analysis showed that only mMRC scores,DLCO%Pred,and SpO2rest were independently associated with DDR. Conclusion: Continuous SpO2 monitoring during the 6MWT,with parameters such as SpO2mean,DA,DDR,and 6MWD%Pred,can effectively reflect pulmonary function and symptoms of stable COPD patients,suggesting its efficacy in assessment and management of COPD patients.

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陈幼花,李瑞久,倪艾珺,王诗绮,李莉,宋玮,孙培莉. COPD患者6MWT下指脉氧特点及运动耐力相关因素分析[J].南京医科大学学报(自然科学版),2024,(8):1082-1091

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  • 收稿日期:2024-03-06
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  • 在线发布日期: 2024-08-09
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