Association of chronic cough and pulmonary function with 6-minute walk test performance in HIV infection.
Association of chronic cough and pulmonary function with 6-minute walk test performance in HIV infection.
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HIV 感染者慢性咳嗽和肺功能与 6 分钟步行测试表现的关系。
DOI：
10.1097/qai.0000000000000086
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发表时间：
2014-04-15
期刊：
影响因子：
--
通讯作者：
Crothers K
中科院分区：
文献类型：
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作者：
Campo M;Oursler KK;Huang L;Goetz MB;Rimland D;Hoo GS;Brown ST;Rodriguez-Barradas MC;Au D;Akgün KM;Shahrir S;Crothers K
慢性肺部疾病与艾滋病毒患者自我报告的身体功能受损程度更大有关。我们试图使用物理或肺功能的客观测量来研究这种联系。HIV相关性肺气肿(呼气)研究的基线数据，这是一项由HIV感染和未感染的退伍军人组成的多中心观察队列。我们评估了6分钟步行试验(6-MWT)中临床、实验室和肺功能指标之间的相关性。建立了多变量线性回归模型以确定与6-MWT表现相关的因素。340名参与者完成了6-MWT(平均年龄55岁)，其中68%是黑人，94%是男性，62%是现在的吸烟者。总体而言，180人(53%)感染艾滋病毒，63人(19%)患有肺活量测定定义的慢性阻塞性肺疾病。在多变量模型中，年龄、当前吸烟和肥胖(BMI>；30)与较低的6-MWT表现独立相关，但HIV感染没有；HIV感染与慢性咳嗽之间存在显著的交互作用，因此与没有咳嗽或HIV的HIV感染者相比，患有慢性咳嗽的HIV感染者步行距离减少了51.76米(p=0.04)。在感染艾滋病毒的参与者中，一秒用力呼气量(FEV1，预测百分比)比总肺活量或弥散量更大程度上减弱了与慢性咳嗽的关联；在HIV感染者中，FEV1降低与6-MWT成绩降低独立相关。高龄、当前吸烟和气流受限是HIV感染参与者6-MWT表现的重要决定因素。这些发现表明，改善身体功能的潜在干预措施可能包括早期管理呼吸道症状和气流限制。
Chronic lung disease has been associated with greater impairment in self-reported physical function in HIV patients. We sought to study this association using objective measures of physical or pulmonary function. Baseline data from the Examinations of HIV Associated Lung Emphysema (EXHALE) study, a multicenter observational cohort of HIV-infected and uninfected Veterans. We assessed the association between clinical, laboratory, and pulmonary function measures on six-minute walk test (6-MWT). Multivariable linear regression models were generated to identify factors associated with 6-MWT performance. 340 participants completed 6-MWT (mean age 55 years), with 68% black race, 94% men and 62% current smokers. Overall, 180 (53%) were HIV-infected and 63 (19%) had spirometry-defined COPD. In a multivariable model, age, current smoking, and obesity (BMI>30) were independently associated with lower 6-MWT performance, but HIV infection was not; there was a significant interaction between HIV and chronic cough, such that distance walked among HIV-infected participants with chronic cough was 51.76 meters less (p=0.04) compared to those without cough or HIV. Among HIV-infected participants, the forced expiratory volume in one second (FEV1, % predicted), to a greater extent than total lung capacity or diffusion capacity, attenuated the association with chronic cough; decreased FEV1 was independently associated with lower 6-MWT performance in those with HIV. Older age, current smoking and airflow limitation were important determinants of 6-MWT performance in the HIV-infected participants. These findings suggest potential interventions to improve physical function may include early management of respiratory symptoms and airflow limitation.