苏歆洁,王亚楠,李丹瑞,等.间质性肺疾病患者股四头肌功能与运动能力的相关性研究[J].中华物理医学与康复杂志,2026,48(6):540-550
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| 间质性肺疾病患者股四头肌功能与运动能力的相关性研究 |
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| DOI：10.3760/cma.j.cn421666-20250620-00512 |
| 中文关键词: 间质性肺疾病 股四头肌功能 等速肌力测试 运动能力 6分钟步行测试 |
| 英文关键词: Interstitial lung disease Quadriceps function Isokinetic muscle strength testing Exercise capacity Six-minute walk test |
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| 目的 探讨间质性肺疾病（ILD）患者股四头肌功能与运动能力的相关性及其影响因素，为ILD患者运动康复方案的精准制定提供循证依据。 方法 横断面研究纳入2023年12月1日至2025年1月1日在吉林大学白求恩第一医院呼吸与危重症医学科就诊的76例ILD患者。收集一般资料、肺功能指标、呼吸肌力、实验室指标等。所有患者均接受了等速肌力测试（IMST）和6分钟步行试验（6MWT），以60°/s的角速度时最高峰值扭矩（PT）作为股四头肌力量（QS）的量度，以180°/s的角速度时30次收缩系列中的交付功总量（TW）作为股四头肌耐力(QE)的量度，以6分钟步行距离（6MWD）评估运动能力，指脉氧仪监测最低脉搏血氧饱和度（SpO2）。采用SPSS 27.0软件进行组间比较和相关性分析；构建性别校正的2个多元逐步线性回归模型，用以分析影响6MWD的因素。模型1仅纳入股四头肌功能与肺功能指标；模型2进一步纳入该研究中所有与6MWD显著相关的变量。 结果 男性和女性患者在身高、体重、6MWD、6MWT中最低SpO2、PT、TW、用力肺活量（FVC）、一氧化碳弥散量（DLCO）、最大吸气压（MIP）等指标存在显著差异，且男性患者股四头肌功能与6MWD的相关性在强度上相对女性组更为突出。PT与身高、体重、血钾浓度、激素治疗显著相关；TW与年龄、身高、第一秒用力呼气量（FEV1）、FVC、白蛋白显著相关；PT与TW显著正相关。性别调整后单因素分析显示，年龄、PT、TW、FEV1、FVC、白蛋白、γ-谷氨酰转肽酶（γ-GT）与6MWD显著相关。经性别调整后多元逐步线性回归分析，模型1结果显示PT、TW、FEV1均为6MWD的独立预测因子（调整后R2=0.43）；模型2结果显示TW仍是6MWD的最强独立预测因子，同时年龄、FEV1、白蛋白、γ-GT也为独立影响因素，而PT不再是独立预测因子。 结论 ILD患者股四头肌功能与运动能力存在性别差异；TW是影响6MWD的最强独立预测因子，运动能力同时受年龄、肺功能、营养状态及肝功能指标的调控。 |
| 英文摘要: |
| Objective To quantify the correlation between quadriceps functioning and the exercise capacity of persons with interstitial lung disease (ILD) and define the main factors which influence it. Methods Seventy-six persons with ILD participated. All underwent isokinetic muscle strength testing (IMST) and performed the 6-minute walk test. The peak torque (PT) they could generate at 60°/s angular velocity was used to quantify quadriceps strength, while total work (TW) during 30 contractions at 180°/s quantified quadriceps endurance. Their 6-minute walk test distance (6MWD) quantified their exercise capacity. Results The male and female subjects differed significantly in average height, weight and many other respects. The correlation between TW at 180°/s and 6MWD was significantly stronger among the males. But in both groups, PT correlated significantly with height, weight, and serum potassium, while TW correlated with age, height, FEV1 and forced vital capacity (FVC). There was a significant positive correlation between PT and TW. 6MWD was correlated with FEV1, FVC, PT, TW and albumin. Gender-adjusted univariate analysis revealed age, PT, TW, FEV1, FVC, albumin, and γ- glutamyl transpeptidase as significant predictors of 6MWD. Gender-adjusted multivariate stepwise regression modeling showed that PT, TW and FEV1 were all independent predictors of 6MWD (adjusted R2=0.43), with TW the strongest independent predictor. Age, FEV1, albumin, and γ-GT also emerged as independent predictive factors, but PT was then no longer a significant independent predictor. Conclusions Total work during 30 contractions at 180°/s is the strongest independent predictor of exercise capacity, but it is also influenced by age, lung function, nutritional status, and liver function. |
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