Department of Internal Medicine, University of Giessen Lung Center, Giessen, Germany.
Respir Med. 2012 Feb;106(2):308-13. doi: 10.1016/j.rmed.2011.10.018. Epub 2011 Nov 18.
Patients with pulmonary arterial hypertension often present with a mild obstructive lung pattern, however, the functional consequences are not known.
We analysed flow volume loops during exercise in 61 patients with precapillary pulmonary hypertension (PH) (age 55 ± 14 years) in comparison with 21 patients with COPD (60 ± 12 years), 39 patients with pulmonary fibrosis (58 ± 11 years) and 38 healthy controls (HC) (39 ± 15 years). Inspiratory capacity (IC) was measured at rest, and during maximum exercise (max).
HC exhibited a stable IC of 3.0 ± 0.9 l at rest, and at max. A reduction in IC of 2.6 ± 0.8 l at rest to 2.0 ± 0.7 l at max was observed in patients with COPD. Patients with PH exhibited a significant reduction in IC from 2.3 ± 0.6 l at rest to 2.1 ± 0.6 l at max, while patients with pulmonary fibrosis exhibited a stable IC of 1.8 ± 0.6 at rest and 1.7 ± 0.6 l at max. In patients with PH, a weak negative correlation was drawn between the change in IC (%) and peak VO2 (r = -0.29, p = 0.01), as well as with PVR (r = -0.27, p = 0.02).
Patients with PH demonstrate a characteristic change in IC during exercise, which might contribute to impaired exercise tolerance.
肺动脉高压患者常表现为轻度阻塞性肺模式，但功能后果尚不清楚。
我们分析了 61 例毛细血管前肺动脉高压（PH）患者（年龄 55±14 岁）、21 例慢性阻塞性肺疾病（COPD）患者（60±12 岁）、39 例肺纤维化患者（58±11 岁）和 38 例健康对照者（HC）（39±15 岁）运动时的流量-容积环。在休息和最大运动时测量吸气量（IC）。
HC 在休息时的 IC 稳定在 3.0±0.9 l，在最大运动时为 3.0±0.9 l。COPD 患者在休息时的 IC 减少了 2.6±0.8 l，最大运动时减少了 2.0±0.7 l。PH 患者的 IC 从休息时的 2.3±0.6 l 显著减少到最大运动时的 2.1±0.6 l，而肺纤维化患者在休息时和最大运动时的 IC 稳定在 1.8±0.6 l。在 PH 患者中，IC 变化（%）与峰值 VO2（r=-0.29，p=0.01）和 PVR（r=-0.27，p=0.02）之间存在弱负相关。
PH 患者在运动时表现出 IC 的特征性变化，这可能导致运动耐量受损。
