[最大强度下气体交换对慢性阻塞性肺疾病患者运动能力的影响]

[Effect of gas exchange at maximal intensity on exercise capacity in patients with chronic obstructive pulmonary disease].

作者信息

Wang Hao-Yan, Xu Qiu-Fen, Xiao Yao

机构信息

Department of Respiratory Disease, Beijing Friendship Hospital, Capital University of Medical Science, Beijing 100050, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2008 Jun;31(6):414-6.

PMID:19031799

Abstract

OBJECTIVE

To investigate the effect of gas exchange at maximal intensity on exercise capacity in patients with chronic obstructive pulmonary disease (COPD).

METHODS

Forty-two male patients with COPD and 26 normal subjects performed incremental exercise test on cycle ergometer. Oxygen uptake and carbon dioxide output were measured continuously on the breath-by-breath mode. Arterial blood samples were drawn at maximal exercise. PaO2, PaCO2, the actual dead space/tidal volume ratios (V(D)/V(T)) and the alveolar-arterial PaO2 difference [ P(A-a) O2 ] were measured and calculated. Comparisons between the two groups were performed using independent samples t test. Linear regression analyses were made between maximal oxygen uptake (VO2max) and blood gas variables.

RESULTS

VO2max in patients with COPD [(16 +/- 4) ml kg(-1) min(-1)] was significantly lower than in normal subjects [(19 +/- 6) ml kg(-1) min(-1)]. P(A-a)O2, V(D)/V(T) and PaCO2 were greater in patients [(43 +/- 3) mm Hg, 1 mm Hg =0.133 kPa, 0.35 +/- 0.11, (33 +/- 11) mm Hg] than in normal subjects at peak exercise [(40 +/- 5) mm Hg, 0.27 +/- 0.08, (15 +/- 7) mm Hg]. VO2max correlated strongly with V(D)/V(T) at peak exercise in patients (r = -0.734, P < 0.01).

CONCLUSION

The increase in V(D)/V(T) inducing ventilatory inefficiency during exercise is one of the important causes for decreased exercise capacity in patients with COPD.

摘要

目的

探讨最大强度气体交换对慢性阻塞性肺疾病（COPD）患者运动能力的影响。

方法

42例男性COPD患者和26例正常受试者在功率自行车上进行递增运动试验。采用逐次呼吸模式连续测量摄氧量和二氧化碳排出量。在最大运动时采集动脉血样本。测量并计算动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）、实际死腔/潮气量比值（V(D)/V(T)）和肺泡-动脉血氧分压差[P(A-a)O2]。两组间比较采用独立样本t检验。对最大摄氧量（VO2max）与血气变量进行线性回归分析。

结果

COPD患者的VO2max[（16±4）ml·kg-1·min-1]显著低于正常受试者[（19±6）ml·kg-1·min-1]。在运动峰值时，COPD患者的P(A-a)O2、V(D)/V(T)和PaCO2[（43±3）mmHg，1mmHg = 0.133kPa，0.35±0.11，（33±11）mmHg]高于正常受试者[（40±5）mmHg，0.27±0.08，（15±7）mmHg]。在COPD患者中，运动峰值时VO2max与V(D)/V(T)密切相关（r = -0.734，P < 0.01）。