Teramoto S, Fukuchi Y, Nagase T, Matsuse T, Shindo G, Orimo H
Department of Geriatrics, Faculty of Medicine, University of Tokyo, Japan.
Chest. 1992 Nov;102(5):1362-6. doi: 10.1378/chest.102.5.1362.
Incremental exercise testing using a cycle ergometer was performed in eight patients with giant bulla before and after bullectomy to assess dyspnea. There was a significant positive linear relationship between dyspnea expressed in the Borg scale (BS) and oxygen consumption (VO2) during exercise in all subjects. From these correlations, we introduced the following three new parameters for quantitative assessment of dyspnea: the Borg scale slope (BSS); the threshold load of dyspnea (TLD); and the breakpoint load of dyspnea (BLD), representing the slope of the regression line, onset of dyspnea on the regression line, and the maximum oxygen consumption before the subjects interrupted exercise, respectively. After surgery, the BSS showed marked decrease, and the TLD and BLD showed significant increase. Therefore, the reduction in the dyspnea with peak exercise after surgery was thought to be, at least in part, based on the delay of dyspnea onset, the decrease in dyspnea sensitivity, and the improvement in exercise capacity. The improvement in dyspnea during exercise in patients with giant bulla after surgery was extensively evaluated by newly introduced parameters based on BS-VO2 regression line.
对8例巨大肺大疱患者在肺大疱切除术前和术后使用自行车测力计进行递增运动试验以评估呼吸困难。在所有受试者中，运动期间用Borg量表（BS）表示的呼吸困难与耗氧量（VO2）之间存在显著的正线性关系。基于这些相关性，我们引入了以下三个用于定量评估呼吸困难的新参数：Borg量表斜率（BSS）；呼吸困难阈值负荷（TLD）；以及呼吸困难断点负荷（BLD），分别代表回归线的斜率、回归线上呼吸困难的起始点以及受试者中断运动前的最大耗氧量。术后，BSS显著降低，TLD和BLD显著增加。因此，术后运动高峰时呼吸困难的减轻至少部分是基于呼吸困难发作的延迟、呼吸困难敏感性的降低以及运动能力的改善。通过基于BS-VO2回归线新引入的参数，对巨大肺大疱患者术后运动期间呼吸困难的改善进行了广泛评估。
