6 min 步行试验和评分量表评估COPD的预后
1 广西壮族自治区人民医院呼吸与危重症医学科，南宁 530021
2 广西崇左市宁明县海渊镇中心卫生院综合科，广西 崇左 532504
目的：探讨中、重度慢性阻塞性肺疾病急性加重期(acute exacerbations of obstructive pulmonary disease，AECOPD)患者肺功能、6 min步行试验(six-minute walk test，6MWT)和COPD评估测试(chronic obstructive pulmonary disease assessment test，CAT)的相关性及临床意义。方法：选择2019年1月至12月在广西壮族自治区人民医院呼吸与危重症医学科住院治疗的75例中、重度AECOPD患者(中度14例，重度31例，极重度30例)，入院后第2天下午由经过培训的专职护士进行肺功能检查、CAT评分、6MWT及6MWT结束或中断后的呼吸困难评分(BORG评分)，并如实记录结果。结果：肺功能分级越重，6 min步行距离(six-minute walk distance，6MWD)越短，FEV1%越低，则BORG、CAT评分越高，且6MWD中断发生率越高，在极重度患者中6MWD发生率为93.3%；CAT分级与肺功能分级之间呈正相关(P<0.01)；CAT分级与6MWD之间呈负相关(P<0.01)，6MWD与FEV1%呈正相关(P<0.01)；ROC曲线显示：6MWD<234 m、BORG评分>6.5、CAT>24时，为预测未来急性加重风险的最佳值。结论：CAT和6MWT联合可综合评估中、重度AECOPD住院患者治疗前病情严重程度、运动和生活自理能力，及指导康复治疗方案。
Evaluation of the prognosis of COPD with six-minute walk test and rating scale
CorrespondingAuthor: QIN Xuejun
This work was supported by the National Natural Science Foundation (81460250), the Natural Science Foundation of Guangxi Zhuang Autonomous Region (2012GXNSFAA053128), and the Health and Family Planning Committee of Guangxi Zhuang Autonomous Region (Z2015676), China.
Objective: To investigate the correlation and clinical significance of pulmonary function test, 6-minute walk test (6MWT) and chronic obstructive pulmonary disease assessment test (CAT) in patients with acute exacerbation of moderate to severe chronic obstructive pulmonary disease (AECOPD). Methods: Between January 2019 and December 2019, 75 cases who were hospitalized in the Department of Respiratory and Critical Care Medicine, Guangxi Zhuang Autonomous Region People’s Hospital were selected, including moderate and severe AECOPD patients (14 moderate cases, 31 severe cases, 30 extremely severe cases). The results of the pulmonary function test, CAT score, 6MWT, and dyspnea score (BORG score) after 6MWT completion or interruption were faithfully recorded by trained nurses on the afternoon of the second day after admission. Results: The heavier the pulmonary function grade was, the shorter the 6-minute walking distance (6MWD) was, and the lower FEV1% was, and the higher the BORG and CAT levels were, and the higher the interruption rate of 6MWD was. The incidence of extremely severe patients was 93.3%. There was a positive correlation between CAT classification and pulmonary function classification (P<0.01), a negative correlation between CAT classification and 6MWD (P<0.01), and a positive correlation between 6MWD and FEV1% (P<0.01). The ROC curve showed that when 6MWD was less than 234 m, BORG score was higher than 6.5 and CAT was higher than 24, which were the best values for predicting future risks. Conclusion: Combined CAT and 6MWT can comprehensively evaluate the severity of disease, exercise and self-care ability before treatment in hospitalized patients with moderate to severe acute exacerbation of chronic obstructive pulmonary disease, as well as guide the rehabilitation treatment plan.
chronic obstructive pulmonary disease; CAT score; six-minute walk test; BORG score; lung function