EFFECT OF ARTERIAL OXYGEN DESATURATION ON 6 MINUTE WALK DISTANCE, PERCEIVED EFFORT, AND PERCEIVED BREATHLESSNESS IN PATIENTS WITH AIR-FLOW LIMITATION
EFFECT OF ARTERIAL OXYGEN DESATURATION ON 6 MINUTE WALK DISTANCE, PERCEIVED EFFORT, AND PERCEIVED BREATHLESSNESS IN PATIENTS WITH AIR-FLOW LIMITATION
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DOI：
10.1136/thx.48.1.33
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发表时间：
1993-01-01
期刊：
影响因子：
10
通讯作者：
SPIRO, SG
中科院分区：
文献类型：
--
作者：
MAK, VHF;BUGLER, JR;SPIRO, SG
背景运动引起的低氧血症在确定次最大运动能力、感知呼吸困难和感知用力方面的影响尚不清楚。本研究的目的是探讨这些变量的关系，肺功能测试的结果和低氧血症的程度，在亚极量运动气流limited.Methods 42例慢性阻塞性气道疾病和28例慢性重度哮喘患者进行了研究。进行肺量测定，并测量气体转移（TLCO）和肺容量。次极量运动能力采用标准化6分钟步行试验进行评估。在步行试验期间，通过便携式脉搏血氧仪监测动脉氧饱和度下降。患者在行走前根据医学研究理事会（MRC）呼吸困难量表评定其感知的呼吸障碍程度。结果6 min步行距离与TLCO呈显著正相关（r值），与TLCO呈显著正相关（r值），与TLCO呈显著负相关（r值（0.68），呼气峰流量（PEF：0.SS），一秒钟用力呼气量（FEV 1：0.53），传递系数KCO：0-49），年龄（-0.49）和用力肺活量（FVC：0.48），但不与步行过程中的氧饱和度下降。步行距离也与MRC量表上的呼吸困难评分（-0.52）相关，但与呼吸困难（-0.35）和体力消耗（-0.30）的相关性较低。通过多元回归分析产生的6分钟步行距离（以米为单位）（6 MD）的预测方程为6 MD = 387 + 29-7（TLCO）-3.1（年龄）+0.35（PEF 1/min），其占步行距离总方差的50%。步行期间的平均饱和度水平与TLCO（0.55）、FEV 1/FVC（0.54）和PEF（0.48）相关性最显著，但与步行距离或任何模拟量表的评分无关。多元回归分析得出步行过程中平均血氧饱和度的预测方程为MEANSAT（%）-1.3（TLCO）+1-5（基线血氧饱和度）-0.01（6 MD）-54。结论6 min步行过程中的血氧饱和度下降与步行距离无关，也不决定气流受限患者的感觉劳累或感觉呼吸困难程度。认为自己因呼吸困难而残疾最严重的患者的6分钟步行距离最短，但不一定有明显的去饱和。
Background The effect of exercise induced hypoxaemia in determining submaximal exercise capacity, perceived breathlessness, and perceived exertion is not known. The purpose of this study was to investigate the relation of these variables to the results of lung function tests and the degree of hypoxaemia during submaximal exercise in patients with airflow limitation.Methods Forty two patients with chronic obstructive airways disease and 28 patients with chronic severe asthma were studied. Spirometry was performed and gas transfer (TLCO) and lung volumes were measured. Submaximal exercise capacity was assessed with a standardised six minute walk test. Arterial oxygen desaturation during the walk test was monitored by a portable pulse oximeter. Patients rated their perceived degree of respiratory impairment on a Medical Research Council (MRC) breathlessness scale before the walk. Perceived breathlessness was measured by means of a linear visual analogue scale and exertion on the Borg scale after the walk.Results The six minute walk distance was strongly correlated (r value) with TLCO (0.68), peak expiratory flow (PEF: 0.SS), forced expiratory volume in one second (FEV1: 0.53), transfer coefficient KCO: 0-49), age (-0.49), and forced vital capacity (FVC: 0.48) but not with oxygen desaturation during the walk. Walk distance was also correlated with the breathlessness rating on the MRC scale (-0.52), but less strongly with perceived breathlessness (-0.35) and perceived exertion (-0.30). The prediction equation for the six minute walk distance in metres (6MD) generated by multiple regression analysis was 6MD = 387 + 29-7 (TLCO) -3.1(age) + 0.35(PEF 1/min), which accounted for 50% of the total variance in walk distance. The mean level of saturation during the walk correlated most significantly with TLCO (0.55), FEV1/FVC (0.54), and PEF (0.48), but not with walk distance or with the rating on any of the analogue scales. The prediction equation produced by multiple regression analysis for the mean level of saturation during the walk was MEANSAT(%) - 1.3(TLCO) + 1-5 (baseline saturation) - 0.01(6MD) - 54.Conclusions Oxygen desaturation during the six minute walk is not related to walk distance, nor does it determine the degree of perceived exertion or perceived breathlessness in patients with airflow limitation. Patients who consider themselves the most disabled by breathlessness have the shortest six minute walk distance but do not necessarily have appreciable desaturation.