Lung function tests in patients with idiopathic pulmonary fibrosis - Are they helpful for predicting outcome?
Lung function tests in patients with idiopathic pulmonary fibrosis - Are they helpful for predicting outcome?
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DOI：
10.1378/chest.111.1.51
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发表时间：
1997-01-01
期刊：
影响因子：
9.6
通讯作者：
Loddenkemper, R
中科院分区：
文献类型：
--
作者：
Erbes, R;Schaberg, T;Loddenkemper, R
研究目的：特发性肺纤维化(IPF)的病程千差万别。为了评估入院时的预测参数，我们调查了99名IPF患者(47名女性)，重点是广泛的肺功能测试。方法：进行标准的肺容量、动脉血氧分压和静息和踏车运动时的气体交换测试。存活率与功能参数的关系使用精算方法计算。结果：大多数患者发病时总肺活量(TLC)下降79.2+/-21.1%，动脉血氧分压(PaO2)病理性下降63%，与年龄相关的PaO2下降11.8+/-12.1 mm Hg，肺泡-动脉血氧分压差升高46.4+/-16.4(12.2~76.8)mm Hg。存活率降低与年龄大于50岁、仅TLC、或合并肺活量减少有关。不影响生存的因素是性别、安静时的气体交换参数以及安静时和骑自行车运动时的PaO2。结论：我们得出结论：标准的肺功能测试可以评估IPF患者的预后，而广泛的测试，如安静时和骑自行车运动时的气体交换测量，并不能提供额外的信息来使预后估计更准确。
Study objective: Idiopathic pulmonary fibrosis (IPF) varies widely in its course. To evaluate predictive parameters at presentation to the hospital, we investigated 99 patients with IPF (47 women), focusing on extensive lung function tests.Methods: Standard tests of lung volumes, arterial oxygen tension, and gas exchange at rest and during bicycle exercise were performed. Survival rates in relation to functional parameters were calculated using the actuarial method. Differences in survival proportions were summarized as hazard ratios, and significance levels were determined by log-rank test.Results: At presentation, most patients showed a reduced total lung capacity (TLC) of 79.2+/-21.1%, an arterial oxygen tension (PaO2) considered pathologic in 63%, when related to age, a significant decrease of PaO2 with 11.8+/-12.1 mm Hg and an increase of the alveolar-arterial oxygen pressure difference with 46.4+/-16.4 (12.2 to 76.8) mm Hg during bicycle exercise. Diminished survival was associated with an age older than 50 years, a reduced value to more than 2 SDs below the predicted values of both, TLC alone, or in combination with a reduced vital capacity. Factors not influencing survival were gender, parameters of gas exchange at rest, and PaO2 at rest and during bicycle exercise.Conclusions: We conclude that standard lung function tests make it possible to assess the prognosis of patients with IPF, while extensive tests like gas exchange measurements at rest and during bicycle exercise do not contribute additional information to make the prognostic estimations more precise.