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重度慢性阻塞性肺疾病患者运动期间动脉氧合的相关因素

Correlates of arterial oxygenation during exercise in severe chronic obstructive pulmonary disease.

作者信息

D'Urzo A D, Mateika J, Bradley D T, Li D, Contreras M A, Goldstein R S

机构信息

Department of Medicine, University of Toronto West Park, Wellesley, Ontario, Canada.

出版信息

Chest. 1989 Jan;95(1):13-7. doi: 10.1378/chest.95.1.13.

Abstract

In the present study, we have undertaken a detailed analysis of the respiratory physiologic correlates of SaO2 during mild constant-load exercise in 38 patients with severe but stable COPD. Several respiratory physiologic variables that would be expected to influence exercise SaO2 were entered into a stepwise multiple linear regression analysis with mean exercise SaO2 as the dependent variable. Two variables (Dco and resting SaO2) were found to correlate strongly with mean exercise SaO2 (multiple r = 0.80; p less than 0.00001) and accounted for 65 percent of the variability among patients. The PaCO2 influenced resting SaO2 but had no independent influence on exercise SaO2. Subsequently, the model of mean exercise SaO2 derived in the present analysis was found to accurately predict mean exercise SaO2 in a group of 19 similar patients (r = 0.85; p less than 0.0001). While these findings do not establish a cause-and-effect relationship, they may provide clinicians with further insight as to which patients are likely to desaturate during exercise.

摘要

在本研究中,我们对38例重度但病情稳定的慢性阻塞性肺疾病(COPD)患者在轻度恒定负荷运动期间动脉血氧饱和度(SaO₂)的呼吸生理相关因素进行了详细分析。将一些预期会影响运动时SaO₂的呼吸生理变量纳入以运动平均SaO₂为因变量的逐步多元线性回归分析。发现两个变量(一氧化碳弥散量(Dco)和静息SaO₂)与运动平均SaO₂密切相关(复相关系数r = 0.80;p < 0.00001),并解释了患者间65%的变异性。动脉血二氧化碳分压(PaCO₂)影响静息SaO₂,但对运动时SaO₂没有独立影响。随后,发现在本分析中得出的运动平均SaO₂模型能够准确预测另一组19例相似患者的运动平均SaO₂(r = 0.85;p < 0.0001)。虽然这些发现并未确立因果关系,但它们可能为临床医生提供进一步的见解,以了解哪些患者在运动期间可能出现血氧饱和度下降。

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