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COPD 患者运动时骨骼肌氧合与全身摄氧量的关系:一项初步研究。

The relationship between skeletal muscle oxygenation and systemic oxygen uptake during exercise in subjects with COPD: a preliminary study.

机构信息

Department of Physical Therapy, Faculty of Health Science, Kio University, Koryo, Japan.

出版信息

Respir Care. 2012 Oct;57(10):1602-10. doi: 10.4187/respcare.01602. Epub 2012 Mar 13.

Abstract

BACKGROUND

Muscle oxygenation correlates with systemic oxygen uptake (V(O₂)) in normal subjects; however, whether this relationship exists in COPD patients remains unclear. The purpose of this study was to investigate the influence of skeletal muscle oxygenation on V(O₂) during exercise in patients with COPD.

METHODS

Eight subjects performed an incremental cycle ergometer exercise test. We measured ventilation and pulmonary gas exchange with a metabolic measurement system. We also continuously monitored S(pO₂), and measured tissue oxygen saturation (S(tO₂)) in the vastus lateralis with continuous-wave near-infrared spectroscopy. We calculated the muscle oxygen extraction rate (MOER) based on S(pO₂) and S(tO₂). In addition, we calculated Pearson correlation coefficients to examine the relationships between the V(O₂) obtained during exercise testing and the mean values of S(pO₂), S(tO₂), heart rate (HR), and MOER for each 30-second interval of the tests. Finally, we analyzed the relationships between the peak V(O₂) and the slopes of HR/V(O₂), S(pO₂)/V(O₂), S(tO₂)/V(O₂), and MOER/V(O₂).

RESULTS

With the increasing exercise intensity, many subjects showed a gradual decrease in S(tO₂) and S(pO₂), but a gradual increase in HR and MOER. V(O₂) was negatively correlated with S(tO₂) and S(pO₂), and was positively correlated with HR and MOER. However, peak V(O₂) was not correlated with any of the slopes.

CONCLUSIONS

V(O₂) is highly influenced by oxygen utilization in exercising muscles, as well as by blood oxygenation levels and cardiac function. However, the impact of skeletal muscle utilization during exercise on peak V(O₂) varied greatly among the subjects.

摘要

背景

在正常受试者中,肌肉氧合与全身氧摄取量(V(O₂))相关;然而,这种关系在 COPD 患者中是否存在尚不清楚。本研究旨在探讨 COPD 患者运动时骨骼肌氧合对 V(O₂)的影响。

方法

8 名受试者进行递增式踏车运动试验。我们使用代谢测量系统测量通气和肺气体交换。我们还连续监测 S(pO₂),并使用连续波近红外光谱法测量股外侧肌的组织氧饱和度(S(tO₂))。我们根据 S(pO₂)和 S(tO₂)计算肌肉氧摄取率(MOER)。此外,我们计算了 Pearson 相关系数,以检验运动试验中获得的 V(O₂)与测试过程中每个 30 秒间隔的 S(pO₂)、S(tO₂)、心率(HR)和 MOER 的平均值之间的关系。最后,我们分析了峰值 V(O₂)与 HR/V(O₂)、S(pO₂)/V(O₂)、S(tO₂)/V(O₂)和 MOER/V(O₂)斜率之间的关系。

结果

随着运动强度的增加,许多受试者的 S(tO₂)和 S(pO₂)逐渐下降,而 HR 和 MOER 逐渐增加。V(O₂)与 S(tO₂)和 S(pO₂)呈负相关,与 HR 和 MOER 呈正相关。然而,峰值 V(O₂)与任何斜率均无关。

结论

V(O₂)受运动肌肉氧利用、血氧水平和心功能的影响很大。然而,运动时骨骼肌利用对峰值 V(O₂)的影响在受试者之间差异很大。

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