Quintero J I, Borzone G, Leiva A, Villafranca C, Lisboa C
Departamento de Enfermedades Respiratorias, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile.
Rev Med Chil. 1999 Apr;127(4):421-8.
Patients with chronic obstructive pulmonary disease have an increased inspiratory work, since they must overcome high loads due to increased airway resistance.
To determine if the reduction in the metabolic cost of exercise observed in patients with chronic obstructive pulmonary disease (COPD) after inspiratory muscle training, was due to a reduction in the oxygen cost of breathing.
Nine patients with COPD (FEV1 39 +/- 13%) subjected to inspiratory muscle training, using a training load of 30% of maximal inspiratory pressure, during 10 weeks; 5 patients with COPD (FEV1 44 +/- 18%) not subjected to training, and 7 healthy controls (FEV1 110 +/- 10%) were studied. The cost of breathing was calculated as the difference in VO2 measured at rest and after breathing a gas mixture containing air and 5% CO2. Exercise VO2 was measured at submaximal exercise.
Oxygen cost of breathing was increased in patients with COPD and it was inversely correlated with FEV1 (r = -0.86 p < 0.001). Inspiratory muscle training increased maximal inspiratory pressure and decreased exercise VO2. Oxygen cost of breathing increased in six and decreased in three trained patients. Changes in this parameter after training did not correlate with the reduction in exercise VO2 or the increment in maximal inspiratory pressure.
The reduction in exercise VO2 after inspiratory muscle training is not due to a reduction in the oxygen cost of breathing.
慢性阻塞性肺疾病患者的吸气功增加,因为他们必须克服因气道阻力增加而产生的高负荷。
确定慢性阻塞性肺疾病(COPD)患者在进行吸气肌训练后观察到的运动代谢成本降低是否归因于呼吸氧耗的降低。
9例COPD患者(第1秒用力呼气容积[FEV1]为39±13%)在10周内使用最大吸气压力30%的训练负荷进行吸气肌训练;研究了5例未接受训练的COPD患者(FEV1为44±18%)和7名健康对照者(FEV1为110±10%)。呼吸成本计算为静息时和呼吸含空气和5%二氧化碳的混合气体后测得的耗氧量(VO2)之差。在次最大运动时测量运动VO2。
COPD患者的呼吸氧耗增加,且与FEV1呈负相关(r = -0.86,p < 0.001)。吸气肌训练增加了最大吸气压力并降低了运动VO2。6例接受训练的患者呼吸氧耗增加,3例降低。训练后该参数的变化与运动VO2的降低或最大吸气压力的增加无关。
吸气肌训练后运动VO2的降低并非由于呼吸氧耗的降低。