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急性重症哮喘治疗后运动时的心肺反应。

Cardio-respiratory responses to exercise following treatment of acute severe asthma.

作者信息

Cayton R M, Packe G E, Freeman W

机构信息

Department of Respiratory Physiology, East Birmingham Hospital, Bordesley Green East, U.K.

出版信息

Respir Med. 1991 Sep;85(5):413-20. doi: 10.1016/s0954-6111(06)80187-3.

Abstract

Asthmatic patients are encouraged to adopt a normal and active life-style. However, following treatment of acute severe asthma, patients may ask for advice about taking exercise. Serial measurements of the cardio-respiratory responses to continuous work load exercise, were made in asthmatic patients convalescing following hospital treatment of an acute exacerbation. Eighteen asymptomatic patients, (seven male) aged 18-48 years, were studied. The first test was performed within 1 week of admission, when the mean (SD) peak expiratory flow rate (PEFR) was 88 (20)% predicted normal and the arterial oxygen tension (PaO2) was 13.1 (1.4) kPa. No significant differences in the mean cardio-respiratory responses, from the last minute of exercise, were found during the 4-week study. There were no significant differences in the four tests, between the resting PEFR, lowest post-exercise PEFR or % change in PEFR. Also, there were no significant differences in the pre-exercise, end of exercise and recovery (10 min after exercise) PaO2, between the four tests. However, taking the four tests as a whole, significant relationships were found between the recovery PaO2 and the lowest post-exercise PEFR, expressed in absolute terms (r = 0.515, P less than 0.001), and as a percentage of predicted normal (r = 0.533, P less than 0.001); and also between the recovery PaO2 and the % change in PEFR after exercise (r = 0.299, P less than 0.05). It is suggested that a formal exercise test should be performed in convalescent asthmatics wishing to participate in active sports. Patients with exercise-induced asthma may then be identified and treated appropriately.

摘要

鼓励哮喘患者采取正常且积极的生活方式。然而,在急性重症哮喘治疗后,患者可能会寻求关于锻炼的建议。对因急性加重住院治疗后正在康复的哮喘患者进行了连续工作负荷运动时心肺反应的系列测量。研究了18名无症状患者(7名男性),年龄在18 - 48岁之间。首次测试在入院后1周内进行,此时平均(标准差)呼气峰值流速(PEFR)为预测正常值的88(20)%,动脉血氧分压(PaO2)为13.1(1.4)kPa。在为期4周的研究中,未发现运动最后一分钟的平均心肺反应有显著差异。四次测试之间,静息PEFR、运动后最低PEFR或PEFR的变化百分比均无显著差异。此外,四次测试之间,运动前、运动结束时和恢复(运动后10分钟)的PaO2也无显著差异。然而,将四次测试作为一个整体来看,发现恢复时的PaO2与运动后最低PEFR之间存在显著关系,以绝对值表示(r = 0.515,P < 0.001),以预测正常值的百分比表示(r = 0.533,P < 0.001);恢复时的PaO2与运动后PEFR的变化百分比之间也存在显著关系(r = 0.299,P < 0.05)。建议对希望参加剧烈运动的康复期哮喘患者进行正式的运动测试。这样就可以识别出运动诱发性哮喘患者并进行适当治疗。

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