Department of Public Health and Infectious Diseases, Pulmonary Lung Function Unit, La Sapienza University, Rome, Italy.
Respir Physiol Neurobiol. 2011 Dec 15;179(2-3):167-73. doi: 10.1016/j.resp.2011.07.013. Epub 2011 Aug 5.
In patients affected by chronic obstructive pulmonary disease (COPD), cardiopulmonary response to exercise was never related to the severity of emphysema (E) measured by high resolution computed tomography (HRCT). Sixteen patients (age=65±8 yrs; FEV(1)=54±18%pred; RV=160±28%pred) with moderate to severe E (quantified by lung HRCT as % voxels <-910 HU) were exercised on a cycle-ergometer to exhaustion. Oxygen uptake (V˙(O2)), carbon dioxide output (V˙(CO2)), ventilation (V˙(E)), tidal volume (V(T)), and end-tidal P(CO2) (PET(CO2)) derived variables were measured breath-by-breath. The % of E correlated with: (1) the ratio V(Tpeak) (r=0.74; p=0.001); (2) the V˙(E)/V˙(CO2) slope (r=-0.77; p=0.0004); (3) PET(CO2) values at peak exercise (r=0.80; p=0.0001). Also, the %E was strongly predicted by the following exercise equation: %E(EST) = 58.1 + 11.9 × ΔV˙(E)/V˙(CO2) (r=0.94; p<0.0001). A V(Tpeak)/FEV1 ratio>1 is typically observed in severe E patients; furthermore, the V˙(E)/V˙(CO2) slope and the PET(CO2peak) values decrease and increase respectively as more as the emphysema is severe.
在患有慢性阻塞性肺疾病（COPD）的患者中，心肺对运动的反应与高分辨率计算机断层扫描（HRCT）测量的肺气肿（E）严重程度无关。16 名患者（年龄=65±8 岁；FEV1=54±18%预测值；RV=160±28%预测值）患有中重度 E（通过肺部 HRCT 量化为<-910 HU 的体素百分比），在测功机上进行至力竭运动。摄氧量（V˙（O2））、二氧化碳输出量（V˙（CO2））、通气量（V˙（E））、潮气量（V（T））和呼气末 P（CO2）（PET（CO2））衍生变量通过呼吸进行测量。E 的百分比与：（1）V（Tpeak）的比值（r=0.74；p=0.001）；（2）V˙（E）/V˙（CO2）斜率（r=-0.77；p=0.0004）；（3）运动峰值时的 PET（CO2）值（r=0.80；p=0.0001）相关。此外，E 的百分比可以通过以下运动方程强烈预测：%E（EST）=58.1+11.9×ΔV˙（E）/V˙（CO2）（r=0.94；p<0.0001）。在严重 E 患者中，通常观察到 V（Tpeak）/FEV1 比值>1；此外，随着肺气肿的严重程度增加，V˙（E）/V˙（CO2）斜率和 PET（CO2peak）值分别降低和升高。
