在急性肺栓塞后的随访期间,功能能力和呼吸障碍
Ioannis T Farmakis1, Luca Valerio2, Stefano Barco3
1Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany. Electronic address: https://twitter.com/itfarmakis.
Journal of thrombosis and haemostasis : JTH
|August 31, 2023
概括
肺栓塞 (PE) 后异常的六分钟步行距离 (6MWD) 是常见的,并预测长期损伤. 超过一半的异常6MWD患者没有报告呼吸障碍,强调需要客观的功能评估.
科学领域:
- 肺部医学 肺部医学
- 心血管呼吸系统生理学
- 临床研究 临床研究
背景情况:
- 肺栓塞 (PE) 幸存者经常经历持续的功能限制.
- 了解PE后功能能力的决定因素对于患者管理至关重要.
- 长期随访对于鉴定持续局限性的患者至关重要.
研究的目的:
- 在急性肺栓塞 (PE) 后的长期随访期间识别与异常功能能力相关的因素.
- 评估异常六分钟步行距离 (6MWD) 和呼吸障碍的患病率和预测因素.
- 评估异常6MWD与长期结果的关联.
主要方法:
- 对急性PE幸存者的前性队列研究,随访3个月和12个月.
- 评估六分钟步行距离 (6MWD) 和修改的医学研究委员会 (mMRC) 呼吸障碍尺度.
- 使用根据年龄,性别和人类测量调整的参考方程来定义异常的6MWD.
主要成果:
- 在12个月后,18.3%的患者有异常的6MWD,其中52.1%的患者没有报告呼吸障碍.
- 异常的6MWD与年轻的年龄,更高的BMI,吸烟,中等/高风险PE和更高的mMRC等级有关.
- 3个月的异常6MWD预测了随后的PE后损伤和更差的生活质量.
结论:
- 很大一部分PE幸存者在一年内表现出异常的6MWD,通常没有报告呼吸障碍.
- 像6MWD这样的客观功能测量对于识别PE后持续性损伤至关重要.
- 异常的6MWD是长期功能衰退和PE后生活质量降低的关键预测因素.
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