Pouliou E, Nanas S, Papamichalopoulos A, Kyprianou T, Perpati G, Mavrou I, Roussos C
Adult Cystic Fibrosis Outpatient Clinic, Athens Chest Hospital, Greece.
Chest. 2001 Apr;119(4):1073-8. doi: 10.1378/chest.119.4.1073.
To explore the significance of oxygen kinetics during early recovery after maximal cardiopulmonary exercise testing (CPET) in the assessment of functional capacity and severity of the disease in cystic fibrosis (CF) patients.
Eighteen patients with CF (9 male/9 female; mean +/- SD age, 23 +/- 13 years) and 11 healthy subjects (3 male/8 female; mean age, 29 +/- 4 years) underwent maximum CPET on a treadmill. Breath-by-breath analysis was used for measuring oxygen consumption (VO(2)), carbon dioxide production, and ventilation. Maximum VO(2) (VO(2)peak) and the first-degree slope of VO(2) decline during early recovery (VO(2)/t-slope) were calculated. To assess the severity of the disease, we used standard indexes like FEV(1) (% predicted), VO(2)peak, and a widely accepted system of clinical evaluation, the Schwachman score (SS).
VO(2)/t-slope was significantly lower in CF patients compared to healthy subjects (0.61 +/- 0.31 L/min/min vs 1.1 +/- 0.13 L/min/min; p < 0.01) and was closely correlated to FEV(1)(r = 0.90, p < 0.001), VO(2)peak (r = 0.81, p < 0.001), and the SS (r = 0.81, p < 0.001). The multivariate analysis showed that the only independent predictor of the SS is the VO(2)/t-slope.
We conclude that in CF patients, the prolonged oxygen kinetics during early recovery from maximal exercise is related to the disease severity.
探讨最大心肺运动试验（CPET）后早期恢复过程中的氧动力学在评估囊性纤维化（CF）患者的功能能力和疾病严重程度方面的意义。
18例CF患者（9例男性/9例女性；平均±标准差年龄，23±13岁）和11名健康受试者（3例男性/8例女性；平均年龄，29±4岁）在跑步机上进行了最大CPET。逐次呼吸分析用于测量耗氧量（VO₂）、二氧化碳产生量和通气量。计算了最大VO₂（VO₂峰值）和早期恢复过程中VO₂下降的一级斜率（VO₂/t斜率）。为了评估疾病的严重程度，我们使用了标准指标，如FEV₁（预测值百分比）、VO₂峰值，以及一个广泛接受的临床评估系统，即施瓦赫曼评分（SS）。
与健康受试者相比，CF患者的VO₂/t斜率显著更低（0.61±0.31升/分钟/分钟对1.1±0.13升/分钟/分钟；p<0.01），并且与FEV₁密切相关（r = 0.90，p<0.001）、VO₂峰值（r = 0.81，p<0.001）和SS（r = 0.81，p<0.001）。多变量分析表明，SS的唯一独立预测因子是VO₂/t斜率。
我们得出结论，在CF患者中，最大运动后早期恢复过程中延长的氧动力学与疾病严重程度相关。
