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轻度至中度气流受限患者运动时的呼吸:体育锻炼的影响

Breathing during exercise in subjects with mild-to-moderate airflow obstruction: effects of physical training.

作者信息

Pellegrino R, Villosio C, Milanese U, Garelli G, Rodarte J R, Brusasco V

机构信息

Fisiopatologia Respiratoria e Cardiologia, Azienda Ospedaliera S. Croce e Carle, 12100 Cuneo, Italy.

出版信息

J Appl Physiol (1985). 1999 Nov;87(5):1697-704. doi: 10.1152/jappl.1999.87.5.1697.

Abstract

In this study we explored the effects of physical training on the response of the respiratory system to exercise. Eight subjects with irreversible mild-to-moderate airflow obstruction [forced expiratory volume in 1 s of 85 +/- 14 (SD) % of predicted and ratio of forced expiratory volume in 1 s to forced vital capacity of 68 +/- 5%] and six normal subjects with similar anthropometric characteristics underwent a 2-mo physical training period on a cycle ergometer three times a week for 31 min at an intensity of approximately 80% of maximum heart rate. At this work intensity, tidal expiratory flow exceeded maximal flow at control functional residual capacity [FRC; expiratory flow limitation (EFL)] in the obstructed but not in the normal subjects. An incremental maximum exercise test was performed on a cycle ergometer before and after training. Training improved exercise capacity in all subjects, as documented by a significant increase in maximum work rate in both groups (P < 0.001). In the obstructed subjects at the same level of ventilation at high workloads, FRC was greater after than before training, and this was associated with an increase in breathing frequency and a tendency to decrease tidal volume. In contrast, in the normal subjects at the same level of ventilation at high workloads, FRC was lower after than before training, so that tidal volume increased and breathing frequency decreased. These findings suggest that adaptation to breathing under EFL conditions does not occur during exercise in humans, in that obstructed subjects tend to increase FRC during exercise after experiencing EFL during a 2-mo strenuous physical training period.

摘要

在本研究中,我们探讨了体育锻炼对呼吸系统运动反应的影响。八名患有不可逆轻度至中度气流阻塞的受试者[第1秒用力呼气量为预测值的85±14(标准差)%,第1秒用力呼气量与用力肺活量之比为68±5%]和六名具有相似人体测量特征的正常受试者,在周期测力计上进行了为期2个月的体育锻炼,每周三次,每次31分钟,强度约为最大心率的80%。在这个工作强度下,阻塞性受试者在功能残气量[FRC;呼气流量受限(EFL)]时的潮气量呼气流量超过了对照时的最大流量,而正常受试者则没有。在训练前后,在周期测力计上进行了递增式最大运动测试。训练提高了所有受试者的运动能力,两组的最大工作率均显著增加(P<0.001)证明了这一点。在高负荷下相同通气水平时,阻塞性受试者训练后FRC大于训练前,这与呼吸频率增加和潮气量减少的趋势有关。相反,在高负荷下相同通气水平时,正常受试者训练后FRC低于训练前,因此潮气量增加而呼吸频率降低。这些发现表明,在人类运动过程中,在呼气流量受限条件下的呼吸适应并未发生,因为阻塞性受试者在经历了为期2个月的高强度体育锻炼中的呼气流量限后,运动时倾向于增加功能残气量。

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