Brasil Santos Dante, de Assis Viegas Carlos Alberto
Hospital Universitário de Brasília da Universidade de Brasília (HUB/UnB).
Rev Port Pneumol. 2009 Jan-Feb;15(1):11-25. doi: 10.1016/s2173-5115(09)70085-5.
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbid-mortality world wide, leading not only to pulmonary damage but also to multisystemic impairment, with repercussions on skeletal muscles and the ability to undertake effort, as measured in the six-minute walk test (6-MWT).
To correlate the level of obstruction in COPD with lactate concentration and heart rate (HR) at rest, and distance walked. To correlate distance walked with blood gas analysis and correlate desaturation in 6-MWT with post 6-MWT lactate concentration and heart rate.
COPD patients underwent spirometry, blood gas analysis and 6-MWT to evaluate distance walked, heart rate, capillary lactate (CL) concentration pre- and post 6-MWT, and desaturation with 6-MWT.
91 patients with all levels of obstruction were evaluated. HR and CL increased significantly post 6-MWT. The decrease in peripheral saturation of haemoglobin to oxygen observed with 6-MWT was also significant. The distance walked was shorter the greater the obstruction. The correlation analysis was significantly positive between FEV1 and distance walked, negative between FEV(1) and HR at rest and negative between distance walked and PaCO(2), and not significant for the other variables.
Increased obstruction in COPD and higher PaCO(2) values contribute to a reduction in distance walked in 6-MWT. The level of obstruction in COPD leads to a haemodynamic impairment with increased HR at rest of these patients.
慢性阻塞性肺疾病（COPD）是全球发病和死亡的主要原因之一，不仅导致肺部损害，还会引起多系统功能障碍，对骨骼肌以及六分钟步行试验（6-MWT）所测量的运动能力产生影响。
将COPD患者的阻塞程度与静息时的乳酸浓度、心率（HR）以及步行距离进行相关性分析。将步行距离与血气分析进行相关性分析，并将6-MWT中的血氧饱和度下降与6-MWT后的乳酸浓度和心率进行相关性分析。
对COPD患者进行肺功能测定、血气分析和6-MWT，以评估步行距离、心率、6-MWT前后的毛细血管乳酸（CL）浓度以及6-MWT过程中的血氧饱和度下降情况。
对91例不同阻塞程度的患者进行了评估。6-MWT后HR和CL显著升高。6-MWT过程中观察到的血红蛋白外周血氧饱和度下降也很显著。阻塞程度越高，步行距离越短。FEV1与步行距离之间的相关性分析呈显著正相关，FEV1与静息HR之间呈负相关，步行距离与PaCO2之间呈负相关，其他变量之间无显著相关性。
COPD患者阻塞程度增加和较高的PaCO2值会导致6-MWT中步行距离缩短。COPD的阻塞程度导致这些患者静息时HR升高，出现血流动力学损害。
