5次“起-坐”试验在慢性阻塞性肺疾病患者临床评价中的价值

Value of five-repetition sit-to-stand test in clinical evaluation of chronic obstructive pulmonary disease

目的探讨5次"起-坐"试验(5STS)在我国老年慢性阻塞性肺疾病(COPD)患者临床评价中的应用价值。方法入选符合入选标准的COPD患者51例及健康对照20例,收集其一般资料,并完成5STS试验、肺通气功能检查、6 min步行试验(6MWT),及呼吸困难评分(m MRC)、BODE指数评分等。结果所有入选者均能完成5STS试验,两组所行3次5STS时间均具有良好的可重复性(P<0.001),但COPD患者5STS时间12.93±3.11 s较健康对照组10.72±0.71 s明显延长(P=0.002)。无论COPD患者还是健康对照5STS时间与6MWT结果均具有显著负相关(P<0.05),其相关系数分别为-0.611、-0.682;另外,COPD患者5STS时间与第1秒用力呼气容积占预计值百分比(FEV1%预)、体质量指数(BMI)显著负相关,与m MRC、BODE指数显著正相关,P<0.05。结论 5STS试验简便易行、可重复性好,与现有的多数COPD评价指标具有良好的相关性,可有效反映老年COPD患者的活动耐力及疾病严重程度,值得在临床工作中推广应用。

Objective To investigate the value of five-repetition sit-to-stand test （5STS） in clinical evaluation of elderly patients with chronic obstructive pulmonary disease （COPD）. Methods Fifty-one patients with COPD and 20 healthy individuals were enrolled in this study. All the participants underwent 5STS, pulmonary function examination, and 6 min walking test （6MWT） and were evaluated for severity of dyspnea （by mMRC） and BODE index during the tests. Results All the participants completed 5STS test with a good reproducibility of the time used for 3 sessions of the test （P〈0.001）. The mean time used by COPD patients for 5STS was significantly longer than that by healthy individuals （12.93 ± 3.11s vs 0.72 ± 0.71 s, P=0.002）. The results of 5STS showed a significant negative correlation with those of 6MWT in the case group and control group with correlation coefficients of-0.611 and-0.682, respectively. The results of 5STS were negatively correlated with FEV1%Pre and body mass index （P〈0.05） but positively with mMRC and BODE index in COPD patients （P〈0.05）. Conclusion 5STS is a simple and reproducible test to evaluate the patients＆#39; exercise capacity and the severity of COPD, and is well correlated with the current methods for clinical evaluation of COPD.