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[通气无氧阈值对术前评估是否有用?]

[Is ventilatory anaerobic threshold useful for preoperative assessment?].

作者信息

Hirose Y, Okutsu Y

机构信息

Department of Anesthesiology, Kanagawa Prefectural Cardiovascular and Respiratory Center, Yokohama.

出版信息

Masui. 1991 Aug;40(8):1218-21.

PMID:1920799
Abstract

The anaerobic threshold (VAT), obtained by measurement of ventilatory volume and by expiratory gas analysis, and the anaerobic threshold (LAT), obtained directly from the lactic acid value in the blood, were compared and evaluated during exercise load in 25 patients with mitral valve disease. Exercise loading was performed with an ergometer using a multistep method of increases of 5 W (Group A, 11 cases) or 10 W (Group B, 14 cases) per minute. The oxygen uptake value at the points of 0.5 mmol.l-1 and 1.0 mmol.l-1 increase in the lactic acid values when compared with the starting values were designated as 0.5 LAT and 1.0 LAT. VAT was found in 4 of 11 (36%) patients in Group A and in 12 of 14 (86%) patients in Group B and the ratio obtained was significantly higher in Group B than in A. The 0.5 LAT values for Group A and B were 2.4 +/- 0.5 and 2.2 +/- 0.3, respectively. The 1.0 LAT values were 2.9 +/- 0.7 and 2.7 +/- 0.4, and among the two groups no significant difference was found concerning 0.5 LAT or 1.0 LAT. VAT was seen in 16 or 25 patients and the average VAT value of the 16 was roughly at the midpoint between the average values for 0.5 LAT and 1.0 LAT. Therefore in patients in which VAT was seen with the expiratory gas method, VAT and LAT values were basically equivalent. However, in Group A, VAT was seen in only 4 of 11 patients and it is a fact that it is difficult to find VAT without a suitable exercise load.

摘要

通过测量通气量和呼气气体分析获得的无氧阈值(VAT),以及直接从血液乳酸值获得的无氧阈值(LAT),在25例二尖瓣疾病患者的运动负荷期间进行了比较和评估。使用测力计采用每分钟增加5W(A组,11例)或10W(B组,14例)的多步方法进行运动负荷。与起始值相比,乳酸值增加0.5mmol.l-1和1.0mmol.l-1时的摄氧量分别指定为0.5LAT和1.0LAT。A组11例患者中有4例(36%)发现了VAT,B组14例患者中有12例(86%)发现了VAT,B组获得的比例明显高于A组。A组和B组的0.5LAT值分别为2.4±0.5和2.2±0.3。1.0LAT值分别为2.9±0.7和2.7±0.4,两组之间在0.5LAT或1.0LAT方面未发现显著差异。25例患者中有16例发现了VAT,16例的平均VAT值大致在0.5LAT和1.0LAT平均值之间的中点。因此,在通过呼气气体法发现VAT的患者中,VAT和LAT值基本相当。然而,在A组中,11例患者中只有4例发现了VAT,事实上,如果没有合适的运动负荷,很难发现VAT。

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