六分钟步行试验在心脏康复中的临床应用
Clinical Application of Six-Minute Walk Test in Cardiac Rehabilitation
DOI: 10.12677/ACM.2023.1392039, PDF,   
作者: 贾玉平：华北理工大学研究生学院，河北 唐山；马 燚*：唐山工人医院心血管内科，河北 唐山
关键词: 六分钟步行试验；心脏康复；心力衰竭；心脏术后；肺动脉高压；Six-Minute Walk Test； Cardiac Rehabilitation； Heart Failure； After Heart Surgery； Pulmonary Hy-pertension
摘要: 心脏康复(cardiac rehabilitation, CR)作为治疗稳定期心血管疾病以及预防再发心血管事件的重要手段，降低了患有缺血性心脏病、心力衰竭或心脏手术的成人的发病率和死亡率。在心脏康复中，心肺运动试验(cardiopulmonary exercise testing, CPET)是功能评估的黄金标准，但它涉及专业的设备及人员和较高的成本，在临床上并未普遍使用，一种可行的替代方法是六分钟步行试验(six-minute walk test, 6MWT)。6MWT作为一种广泛使用且耐受性良好的测试，可用于客观评价心功能，评估患者的预后、指导心衰患者的治疗及运动康复，在心脏康复的临床应用中有着良好的发展前景。
Abstract: Cardiac rehabilitation (CR) is an important method for the treatment of stable cardiovascular dis-eases and the prevention of recurrent cardiovascular events, reduced morbidity and mortality in adults with coronary artery disease, heart failure, or heart surgery. In cardiac rehabilitation, cardi-opulmonary exercise testing (CPET) is the gold standard for functional assessment, but it involves professional equipment and personnel and is not widely used in clinical practice due to its high cost, a viable alternative is the six-minute walk test (6MWT). As a widely used and well tolerated test, 6MWT can be used to objectively evaluate cardiac function, evaluate the prognosis of patients, guide the treatment of patients with heart failure and exercise rehabilitation, it has a good prospect in the clinical application of cardiac rehabilitation.
文章引用：贾玉平, 马燚. 六分钟步行试验在心脏康复中的临床应用[J]. 临床医学进展, 2023, 13(9): 14579-14587. https://doi.org/10.12677/ACM.2023.1392039

参考文献

[1] 丁荣晶. 《冠心病心脏康复/二级预防中国专家共识》解读[J]. 岭南心血管病杂志, 2013, 19(2): 123-126.
[2] ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories (2002) ATS Statement: Guidelines for the Six-Minute Walk Test. American Journal of Respiratory and Critical Care Medicine, 166, 111-117. [Google Scholar] [CrossRef] [PubMed]
[3] Holland, A.E., Spruit, M.A., Troosters, T., Puhan, M.A., Pepin, V., et al. (2014) An Official European Respiratory Society/American Thoracic Society Technical Standard: Field Walking Tests in Chronic Respiratory Disease. European Respiratory Journal, 44, 1428-1446. [Google Scholar] [CrossRef] [PubMed]
[4] Giannitsi, S., Bougiakli, M., Bechlioulis, A., Kotsia, A., Michalis, L.K., et al. (2019) 6-Minute Walking Test: A Useful Tool in the Management of Heart Failure Patients. Therapeutic Ad-vances in Cardiovascular Disease, 13. [Google Scholar] [CrossRef] [PubMed]
[5] Guyatt, G.H., Sullivan, M.J., Thompson, P.J., Fallen, E.L., Pugs-ley, S.O., et al. (1985) The 6-Minute Walk: A New Measure of Exercise Capacity in Patients with Chronic Heart Failure. Canadian Medical Association Journal, 132, 919-923.
[6] Wright, D.J., Khan, K.M., Gossage, E.M. and Saltissi, S. (2001) Assessment of a Low-Intensity Cardiac Rehabilitation Programme Using the Six-Minute Walk Test. Clinical Re-habilitation, 15, 119-124. [Google Scholar] [CrossRef] [PubMed]
[7] Hamilton, D.M. and Haennel, R.G. (2000) Validity and Relia-bility of the 6-Minute Walk Test in a Cardiac Rehabilitation Population. Journal of Cardiopulmonary Rehabilitation and Prevention, 20, 156-164. [Google Scholar] [CrossRef] [PubMed]
[8] Goble, A.J. and Worcester, M. (1999) Best Practice Guidelines for Cardiac Rehabilitation and Secondary Prevention. Heart Research Centre Department of Human Services Victoria, Victorian State Government, 162.
[9] Bellet, R.N., Adams, L. and Morris, N.R. (2012) The 6-Minute Walk Test in Outpatient Cardiac Rehabilitation: Validity, Reliability and Responsiveness—A Systematic Review. Physiothera-py, 98, 277-286. [Google Scholar] [CrossRef] [PubMed]
[10] Radi, B., Ambari, A.M., Dwiputra, B., et al. (2021) Determi-nants and Prediction Equations of Six-Minute Walk Test Distance Immediately after Cardiac Surgery. Frontiers in Car-diovascular Medicine, 8, Article ID: 685673. [Google Scholar] [CrossRef] [PubMed]
[11] Corvera-Tindel, T., Doering, L.V., Woo, M.A., Khan, S. and Dracup, K. (2004) Effects of a Home Walking Exercise Program on Functional Status and Symptoms in Heart Failure. American Heart Journal, 147, 339-346. [Google Scholar] [CrossRef] [PubMed]
[12] Yap, J., Lim, F.Y., Gao, F., Teo, L.L., Lam, C.S., et al. (2015) Cor-relation of the New York Heart Association Classification and the 6-Minute Walk Distance: A Systematic Review. Clin-ical Cardiology, 38, 621-628. [Google Scholar] [CrossRef] [PubMed]
[13] Halliday, S.J., Wang, L., Yu, C., Vickers, B.P., Newman, J.H., et al. (2020) Six-Minute Walk Distance in Healthy Young Adults. Respiratory Medicine, 165, Article ID: 105933. [Google Scholar] [CrossRef] [PubMed]
[14] 张忠玲, 毛静远. 6分钟步行试验在慢性心力衰竭中的应用思考[J]. 吉林中医药, 2011, 31(7): 629-632. [Google Scholar] [CrossRef] 
[15] Rostagno, C., Olivo, G., Comeglio, M., et al. (2003) Prog-nostic Value of 6-Minute Walk Corridor Test in Patients with Mild to Moderate Heart Failure: Comparison with Other Methods of Functional Evaluation. European Journal of Heart Failure, 5, 247-252. [Google Scholar] [CrossRef] 
[16] Castel, M.A., Méndez, F., Tamborero, D., et al. (2009) Six-Minute Walking Test Predicts Long-Term Cardiac Death in Patients Who Received Cardiac Resynchronization Therapy. Europace, 11, 338-342. [Google Scholar] [CrossRef] [PubMed]
[17] 欧立, 董平剑. 6分钟步行试验对厄贝沙坦治疗充血性心力衰竭的疗效评估[J]. 四川医学, 2011, 32(3): 417-418. [Google Scholar] [CrossRef] 
[18] 侯雅竹, 闫玲燕, 毛静远, 等. 6分钟步行试验在慢性心力衰竭临床评估中的应用价值[J]. 中国循证医学杂志, 2018, 18(9): 907-917.
[19] 陈新馨. 六分钟步行试验用于慢性心力衰竭患者病情及预后评估的临床价值[C]//南京康复医学会. 第三届全国康复与临床药学学术交流会议论文集(二). [出版者不详], 2022: 6.[CrossRef] 
[20] 罗庆, 张林, 赖荣美, 何静, 汪必会. 心脏康复对慢性心衰患者心功能的影响[J]. 实用预防医学, 2022, 29(2): 238-241.
[21] HeartOnline Exercise: Exercise Prescription ([Cited 2018 20 July]. Heart Online Toolkit]. Available from: ACT: National Heart Foundation of Australia, Canberra 2018. http://www.heartonline.org.au/articles/exercise/exercise-prescription
[22] Verrill, D.E., Barton, C., Beasley, W., Lippard, M. and King, C.N. (2003) Six-Minute Walk Performance and Quality of Life Comparisons in North Carolina Cardiac Rehabilitation Programs. Heart Lung, 32, 41-51. [Google Scholar] [CrossRef] [PubMed]
[23] Bellet, R.N., Francis, R.L., Jacob, J.S., Healy, K.M., Bartlett, H.J., et al. (2011) Repeated Six-Minute Walk Tests for Outcome Measurement and Exercise Prescription in Outpatient Cardiac Re-habilitation: A Longitudinal Study. Archives of Physical Medicine and Rehabilitation, 92, 1388-1394. [Google Scholar] [CrossRef] [PubMed]
[24] 陈艳俏, 曲畅, 张成英. 心脏康复对急性冠脉综合征患者的治疗效果评价[J]. 中国妇幼健康研究, 2017, 28(S1): 164-165.
[25] 卜晓佳, 梁涛. 6分钟步行试验在慢性心力衰竭患者中的应用进展[J]. 中国心血管杂志, 2014, 19(2): 158-160.
[26] Poole-Wilson, P.A. (2000) The 6-Minute Walk. A Simple Test with Clinical Application. European Heart Journal, 21, 507-508. [Google Scholar] [CrossRef] [PubMed]
[27] 黄丹丹. 六分钟步行试验训练对慢性心衰患者康复的影响[J]. 医学食疗与健康, 2019(11): 200-201.
[28] Fiorina, C., Vizzardi, E., Lorusso, R., Maggio, M., De Cicco, G., et al. (2007) The 6-Min Walking Test Early after Cardiac Surgery. Reference Values and the Effects of Rehabilitation Programme. European Journal of Cardio-Thoracic Surgery, 32, 724-729. [Google Scholar] [CrossRef] [PubMed]
[29] De Feo, S., Tramarin, R., Lorusso, R. and Faggiano, P. (2009) Six-Minute Walking Test after Cardiac Surgery: Instructions for an Appropriate Use. European Journal of Cardiovascular Prevention & Rehabilitation, 16, 144-149. [Google Scholar] [CrossRef] 
[30] Papathanasiou, J.V., Ilieva, E. and Marinov, B. (2013) Six-Minute Walk Test: An Effective and Necessary Tool in Modern Cardiac Rehabilitation. Hellenic Journal of Cardiol-ogy, 54, 126-130.
[31] 董珺楠, 王丽姿, 毛贵如. 家庭六分钟步行试验对经皮冠状动脉介入术术后患者自我管理的影响[J]. 中国实用护理杂志, 2015, 31(32): 2426-2430.
[32] Santoso, A., Purwowiyoto, S.L., Purwowiyoto, B.S., et al. (2019) Exercise Training Improved Longitudinal Intrinsic Left Ventricle Function in Heart Failure with Preserved Ejection Fraction. International Journal of Angiology, 28, 44-49. [Google Scholar] [CrossRef] [PubMed]
[33] 齐喜玲, 许海燕, 于子凯, 张倩, 赵振燕, 叶蕴青, 王墨扬, 马宁, 吴永健. 六分钟步行试验在经导管主动脉瓣置换术后心脏康复中的指导价值[J]. 中华老年心脑血管病杂志, 2019, 21(7): 695-698.
[34] 中华医学会心血管病学分会, 中国康复医学会心肺预防与康复专业委员会, 中华心血管病杂志编辑委员会. 六分钟步行试验临床规范应用中国专家共识[J]. 中华心血管病杂志, 2022, 50(5): 432-442.
[35] 陈解忠, 丁志坚, 王新, 曹海涛. 急性ST段抬高型心肌梗死患者急诊PCI术中血栓抽吸治疗后半年6MWT的效果分析[J]. 实用临床医药杂志, 2014, 18(21): 17-19.
[36] Opasich, C., De Feo, S., Pinna, G.D., Furgi, G., Pedretti, R., et al. (2004) Distance Walked in the 6-Minute Test Soon after Cardiac Surgery. Toward an Efficient Use in the Individual Patient. Chest, 126, 1796-1801. [Google Scholar] [CrossRef] [PubMed]
[37] Studenski, S., Perera, S., Patel, K., et al. (2011) Gait Speed and Sur-vival in Older Adults. JAMA, 305, 50-58. [Google Scholar] [CrossRef] [PubMed]
[38] 杨媛华. 《中国肺动脉高压诊断与治疗指南(2021版)》解读——肺动脉高压的诊断[J]. 中国实用内科杂志, 2021, 41(8): 696-699. [Google Scholar] [CrossRef] 
[39] 陈柏蓉, 曾伟媚, 简丽梅. 六分钟步行试验在肺动脉高压患者右心功能评估中的应用[J]. 实用医技杂志, 2021, 28(3): 402-403. [Google Scholar] [CrossRef] 
[40] 那荣瑞, 金健, 雷跃昌, 王一帆. 6分钟步行试验在胸外科应用的临床价值和现状[J]. 中国胸心血管外科临床杂志, 2017, 24(4): 310-314.
[41] Rasekaba, T., et al. (2009) The Six-Minute Walk Test: A Useful Metric for the Cardiopulmonary Patient. Internal Medicine Journal, 39, 495-501. [Google Scholar] [CrossRef] [PubMed]
[42] Miyamoto, S., Nagaya, N., Satoh, T., Kyotani, S., Sakamaki, F., et al. (2000) Clinical Correlates and Prognostic Significance of Six-Minute Walk Test in Patients with Primary Pulmonary Hypertension. Comparison with Cardiopulmonary Exercise Testing. American Journal of Respiratory and Critical Care Medicine, 161, 487-492. [Google Scholar] [CrossRef] [PubMed]
[43] Reesink, H.J., et al. (2007) Six-Minute Walk Distance as Pa-rameter of Functional Outcome after Pulmonary Endarterectomy for Chronic Thromboembolic Pulmonary Hypertension. The Journal of Thoracic and Cardiovascular Surgery, 133, 510-516. [Google Scholar] [CrossRef] [PubMed]
[44] Demir, R. and Küçükoğlu, M.S. (2015) Six-Minute Walk Test in Pulmonary Arterial Hypertension. The Anatolian Journal of Cardiology, 15, 249-254. [Google Scholar] [CrossRef] [PubMed]
[45] Redelmeier, D.A., Bayoumi, A.M., Goldstein, R.S. and Guyatt, G.H. (1997) Interpreting Small Differences in Functional Status: The Six Minute Walk Test in Chronic Lung Disease Patients. American Journal of Respiratory and Critical Care Medicine, 155, 1278-1282. [Google Scholar] [CrossRef] [PubMed]
[46] Perera, S., Mody, S.H., Woodman, R.C. and Studenski, S.A. (2006) Meaningful Change and Responsiveness in Common Physical Performance Measures in Older Adults. Journal of the American Geriatrics Society, 54, 743-749. [Google Scholar] [CrossRef] [PubMed]
[47] Spertus, J., Peterson, E., Conard, M.W., Heidenreich, P.A., Krumholz, H.M., et al. (2005) Monitoring Clinical Changes in Patients with Heart Failure: A Comparison of Methods. American Heart Journal, 150, 707-715. [Google Scholar] [CrossRef] [PubMed]
[48] Barnes, H., et al. (2019) Phosphodiesterase 5 Inhibitors for Pulmo-nary Hypertension. The Cochrane Database of Systematic Reviews, 1, CD012621. [Google Scholar] [CrossRef] 
[49] Galiè, N., et al. (2016) 2015 ESC/ERS Guidelines for the Diagnosis and Treatment of Pulmonary Hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmo-nary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). European Heart Journal, 37, 67-119.
[50] Salvi, D., et al. (2021) App-Based Versus Stand-ard Six-Minute Walk Test in Pulmonary Hypertension: Mixed Methods Study. JMIR mHealth and uHealth, 9, e22748. [Google Scholar] [CrossRef] [PubMed]
[51] Gabler, N.B., et al. (2012) Validation of 6-Minute Walk Distance as a Surrogate End Point in Pulmonary Arterial Hypertension Trials. Circulation, 126, 349-356. [Google Scholar] [CrossRef] 
[52] Vachiery, J.L., Yerly, P. and Huez, S. (2012) How to Detect Disease Progression in Pulmonary Arterial Hypertension. European Respiratory Review, 123, 40-47. [Google Scholar] [CrossRef] [PubMed]
[53] Galie, N., Hoeper, M.M., Humbert, M., Torbicki, A., Vachiery, J.L., et al. (2009) Guidelines for the Diagnosis and Treatment of Pulmonary Hypertension. European Respiratory Jour-nal, 34, 1219-1263. [Google Scholar] [CrossRef] [PubMed]
[54] Provencher, S., Sitbon, O., Humbert, M., Cabrol, S., Jais, X., et al. (2006) Long-Term Outcome with First-Line Bosentan Therapy in Idiopathic Pulmonary Arterial Hypertension. Euro-pean Heart Journal, 27, 589-595. [Google Scholar] [CrossRef] [PubMed]
[55] Fritz, J.S., et al. (2013) Baseline and Follow-Up 6-Min Walk Distance and Brain Natriuretic Peptide Predict 2-Year Mortality in Pulmonary Arterial Hypertension. Chest, 143, 315-323. [Google Scholar] [CrossRef] [PubMed]
[56] Mereles, D., et al. (2006) Exercise and Respiratory Training Improve Exercise Capacity and Quality of Life in Patients with Severe Chronic Pulmonary Hypertension. Circulation, 114, 1482-1489. [Google Scholar] [CrossRef] 

为你推荐