The Significance Of Six-minute Walk Test, Bmi And Mmrc Index In Chronic Obstructive Pulmonary Disease

ObjectiveChronic obstructive pulmonary disease (COPD) is defined as a progressive, usually only partially reversible, obstruction of the airways.Numerous epide-miological studies have shown that COPD is a systemic disease. However the assessment of COPD severity is classificated only by the change of FEV1 until now which is not a comprehensive assessment of COPD severity and prognosis. The validated multidimensional BODE including BMI (B), degree of airflow obstruction as expressed by the FEV1%pred (O), dyspnea with the modified medical research council (D), and exercise (E) measured with the six-minute walk is considered a more comprehensive evaluation of COPD patients. The study discusses the significace of six-minute walk test, the body mass index, modified medical research council(MMRC) dyspnea scale in evaluation of chronic obstructive pulmonary disease severity through comparision among lung ventilation function, six-minute walk test, the body mass index and modified medical research council dyspnea scale.Materials and MethodsEighty patients with COPD were enrolled from Department of Respiratory Medicine in Jinan Military General Hospital from October 2008 to May 2009,including 50 males and 30 females,with a mean age of 62.01±9.34 years,all patients were tested with spirometry,6MWT,BMI and MMRC dyspnea scale. Bivariate correlation was performed in 80 cases to investiget the relationship among spirometry,6MWT,BMI and MMRC dyspnea scale. And all patients were staged due to lung function(FEV1%pred), one way analysis of variance was performed to compare the parameters in each grade.Besides,all patients were tested MMRC dyspnea scale,lung function(FEV1%pred) scale and 6MWD scale and analysis the correlation coefficient and coincidence rate of them. Master Screen lung function machine made in Germany Yeager Company was used in the research. All data analyzed with SPSS for windows 13.0 (x±s) was shown for outcome.Results1.6MWD had a positive linear relationship with FEV1%pred (R=0.620, P<0.01),6MWD had a positive relationship with BMI (R=0.307, P<0.01) 6MWD had a negative relationship with MMRC dyspnea scale(R=-0.705, P<0.01).2. BMI had a positive relationship with FEV1%pred(R=0.245, P<0.05), BMI had a negative relationship with MMRC dyspnea scale(R=-0.323, P<0.05), BMI had a positive relationship with 6MWD (R=0.307, P<0.01).3. MMRC had a negative relationship with FEV1%pred(R=-0.575, P<0.01),Middle(53.8%) and serious(62.5%) patients with COPD had high coincidence rate between MMRC scale and lung function scale.4.The results of comparison of 6MWD in groups of 80 patients who have COPD as follows:there is a significant difference between gradeⅠandⅡ, gradeⅠandⅢ, gradeⅠandⅣ, gradeⅡandⅢ, gradeⅡandⅣwhile there is no difference between gradeⅢandⅣ.5. The results of comparison of BMI in groups of 80 patients who have COPD as follows:there is a significant difference between gradeⅠandⅣ, gradeⅡandⅣ, while there is no difference between gradeⅠandⅡ, gradeⅠandⅢ, gradeⅡandⅢand gradeⅢandⅣ.6.The results of comparison of MMRC in groups of 80 patients who have COPD as follows:there is a significant difference between gradeⅡandⅢ, gradeⅠandⅢ, gradeⅡandⅣ,gradeⅢandⅣ, and gradeⅠandⅣ, while there is no difference between gradeⅠandⅡ.Conclusions1.6MWD had a relationship with FEV1%pred, BMI and MMRC,6MWT is an effective method for detecting COPD patients condition.6MWD scale could be used as an important complemental parameter of staging of COPD,but it isn't suitable for staging COPD independently.2. BMI was an important factor in progress of COPD,it has a relationship with airflow obstruction and exercise. 3. MMRC dyspnea scale was a simple and practical method which had a relationship with FEV]%pred to evaluate the status of middle and serious patients with COPD,but it isn't suitable for staging COPD independently. MMRC dyspnea scale should be recommended to use especially in the hospitals which haven't lung function test equipment.