Kesten S, Garfinkel S K, Wright T, Rebuck A S
Toronto Hospital, Canada.
Chest. 1991 Mar;99(3):663-6. doi: 10.1378/chest.99.3.663.
We measured lung function and exercise tolerance in 15 adults with moderate kyphoscoliosis (thoracic curvatures between 25 degrees and 70 degrees, mean +/- SD = 46.93 degrees +/- 14.02 degrees). Forced vital capacity showed a slight reduction from values predicted from age and sex matched control subjects (3.39 +/- 1.06 vs 4.06 +/- 0.82 L, p less than 0.05). However, exercise tolerance was significantly lower than previously reported in healthy adults (VO2max = 31.60 +/- 9.12 vs 37.07 +/- 4.91 ml/kg/min, p less than 0.05). Despite the reduced exercise tolerance, the ratio of maximum tidal volume to vital capacity (VTmax/VC) was similar to that observed in healthy adults. The mean dyspnea index (VEmax/MVV) was also normal at 69.4 +/- 19.0. Hypoxic and hypercapnic ventilatory responses were within predicted normal limits at 0.67 +/- 0.37 L/min-1 fall in SaO2-1 and 1.67 +/- 0.92 L/min-1 mm Hg PCO2(-1). We conclude that the impairment of exercise performance found in adults with moderate scoliosis cannot be attributed to any important ventilatory limitation, abnormality in lung volume, or impaired chemoreceptor sensitivity. We suggest that the reduced VO2max likely arises from deconditioning and lack of regular aerobic exercise.
我们对15名中度脊柱后凸畸形的成年人（胸弯角度在25度至70度之间，平均±标准差 = 46.93度±14.02度）进行了肺功能和运动耐力测量。用力肺活量较年龄和性别匹配的对照受试者预测值略有降低（3.39±1.06 vs 4.06±0.82 L，p<0.05）。然而，运动耐力显著低于先前报道的健康成年人（最大摄氧量 = 31.60±9.12 vs 37.07±4.91 ml/kg/min，p<0.05）。尽管运动耐力降低，但最大潮气量与肺活量之比（VTmax/VC）与健康成年人相似。平均呼吸困难指数（VEmax/MVV）也正常，为69.4±19.0。低氧和高碳酸通气反应在预测的正常范围内，分别为SaO₂下降1时0.67±0.37 L/min⁻¹和PCO₂下降1时1.67±0.92 L/min⁻¹ mmHg。我们得出结论，中度脊柱侧弯成年人运动能力受损不能归因于任何重要的通气限制、肺容量异常或化学感受器敏感性受损。我们认为最大摄氧量降低可能源于身体机能下降和缺乏规律的有氧运动。
