Kushibe Keiji, Kawaguchi Takeshi, Kimura Michitaka, Takahama Makoto, Tojo Takashi, Taniguchi Shigeki
Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, 840, Shijo-cho, Kashihara, Nara, 634-8522, Japan.
Interact Cardiovasc Thorac Surg. 2008 May;7(3):398-401. doi: 10.1510/icvts.2007.165696. Epub 2008 Feb 12.
The aim of this study is to clarify whether patients with chronic obstructive pulmonary disease (COPD) lose less exercise capacity after lobectomy than do those without COPD, to the same extent as ventilatory capacity and lobectomy for selected patients with severe emphysema improve exercise capacity like ventilatory capacity. Seventy non-COPD patients (N group), 16 mild COPD patients (M group), and 14 moderate-to-severe COPD patients (S group) participated. Pulmonary function and exercise capacity tests were performed on the same day preoperatively and six months to one year after lobectomy. The S group lost significantly less FEV(1) (forced expiratory volume in 1 s) after lobectomy than did the N or M group (P<0.0001 and P<0.005). However, their loss of exercise capacity was equivalent to that for the N and M groups. For the S group, there was a significant, negative correlation between preoperative FEV(1) % of predicted and percentage change in FEV(1) and maximum oxygen consumption (VO2 max) after lobectomy (r=-0.93, P<0.0001 and r=-0.64, P=0.01). In moderate-to-severe COPD patients, patients with a lower preoperative FEV(1) % of predicted experienced a smaller decrease in FEV(1) and VO2 max after lobectomy.
本研究的目的是阐明慢性阻塞性肺疾病(COPD)患者肺叶切除术后运动能力的丧失是否比无COPD患者少,以及对于部分重度肺气肿患者,肺叶切除术改善运动能力的程度是否与改善通气能力相同。70例非COPD患者(N组)、16例轻度COPD患者(M组)和14例中重度COPD患者(S组)参与了研究。在术前同一天以及肺叶切除术后6个月至1年进行了肺功能和运动能力测试。S组肺叶切除术后1秒用力呼气容积(FEV(1))的丧失显著少于N组或M组(P<0.0001和P<0.005)。然而,他们运动能力的丧失与N组和M组相当。对于S组,术前预测FEV(1)百分比与肺叶切除术后FEV(1)和最大耗氧量(VO2 max)的百分比变化之间存在显著的负相关(r=-0.93,P<0.0001和r=-0.64,P=0.01)。在中重度COPD患者中,术前预测FEV(1)百分比越低的患者,肺叶切除术后FEV(1)和VO2 max的下降越小。