30秒坐立试验与慢性阻塞性肺疾病患者运动能力的相关性研究

A study on the correlation between 30-second sit-to-stand test and exercise capacity of patients with chronic obstructive pulmonary disease

目的评价稳定期慢性阻塞性肺疾病(COPD)患者30s内坐立次数与患者运动能力之间的相关性,探讨其可否作为COPD患者运动耐力减退的初筛评价方法。方法共纳入98例稳定期COPD患者,分别完成6分钟步行试验(6MWT)和2次30s坐立试验(30sSTST),并测量患者的股四头肌肌力、肺功能、身高、体质量及BMI等指标。采用Spearman相关系数分析各变量之间的相关性,构建ROC曲线评估30sSTST对6分钟步行距离(6MWD)<350m的预测能力。结果2次30sSTST具有较好的重测信度(ICC=0.975,95%CI:0.962~0.983)。30s坐立次数与6MWD、股四头肌肌力、FEV1%pred、FVC、FEV1/FVC呈显著正相关(P<0.05),相关系数分别为0.466、0.315、0.319、0.262、0.264。ROC曲线结果显示,30s坐立次数<24次,存在运动耐力减退的风险,即6MWD<350m。二元logistic回归分析显示30sSTST是运动耐力减退的决定因素(OR=1.136,95%CI=1.022~1.223,P=0.018)。结论30s坐立次数与6MWD具有显著相关性,因此30sSTST可作为初步评估COPD患者运动耐力的筛选工具。

Objective To evaluate the correlation between the number of sit-to-stand within 30 seconds and exercise capacity in stable patients with chronic obstructive pulmonary disease (COPD),and to discuss whether the sit-to-stand test can be used as the initial screening method for decreased exercise endurance of patients with COPD.Methods Totally 98 patients with stable COPD were recruited,they completed 6 minutes walk test and two 30-second sit-to-stand tests (30sSTST),and researchers measure the patients' quadriceps muscle strength,pulmonary function,height,weight,BMI,etc.We use Spearman correlation coefficient to analyse the correlation between each variable and establish a ROC curve to evaluate the predictive ability of 30 sSTST for 6 minutes walking distance <350m.Results There was a good retest reliability (ICC=0.975,95% CI :0.962-0.983)in the two 30sSTST.The number of sit-to- stand in 30seconds was significantly positively correlated with the 6 minutes walking distance,quadriceps muscle strength,FEV1% pred,FVC,FEV1/FVC (P <0.05),and the correlation coefficients were 0.466,0.315,0.319,0.262,0.264.The ROC curve showed that the number of sit-to-stand in 30seconds was <24,indicating that the patient had a risk of decreased exercise endurance (6 minutes walking distance <350m).Bivariate logistic regression analysis showed that the 30 sSTST was the determinant of exercise intolerance (OR =1.136,95%CI=1.022-1.223,P=0.018).Conclusions The number of sit- to-stand test in 30s and 6-minute walking distance are significant correlated,so 30 sSTST can be used as a preliminary screening tool to evaluate exercise endurance of patients with COPD.