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间质性肺疾病患者有氧运动训练前后的心肺功能

Cardiorespiratory function before and after aerobic exercise training in patients with interstitial lung disease.

作者信息

Keyser Randall E, Woolstenhulme Joshua G, Chin Lisa M K, Nathan Steven D, Weir Nargues A, Connors Gerilynn, Drinkard Bart, Lamberti James, Chan Leighton

机构信息

Department of Rehabilitation Science, George Mason University, Fairfax, VA (Drs Keyser, Woolstenhulme, and Chin); Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD (Drs Keyser, Chin, Chan, and Woolstenhulme and Mr Drinkard); and Department of Medicine (Drs Nathan, Weir, and Lamberti) and Pulmonary Rehabilitation Center, Inova Fairfax Hospital, Falls Church, VA (Ms Connors).

出版信息

J Cardiopulm Rehabil Prev. 2015 Jan-Feb;35(1):47-55. doi: 10.1097/HCR.0000000000000083.

Abstract

PURPOSE

To characterize the cardiorespiratory response to exercise before and after aerobic exercise training in patients with interstitial lung disease.

METHODS

We performed a clinical study, examining 13 patients (New York Heart Association/World Health Organization Functional class II or III) before and after 10 weeks of supervised treadmill exercise walking, at 70% to 80% of heart rate reserve, 30 to 45 minutes per session, 3 times a week. Outcome variables included measures of cardiorespiratory function during a treadmill cardiopulmonary exercise test, with additional near infrared spectroscopy measurements of peripheral oxygen extraction and bioimpedance cardiography measurements of cardiac output. Six-minute walk test distance was also measured.

RESULTS

All subjects participated in at least 24 of their 30 scheduled exercise sessions with no significant adverse events. After training, the mean 6-minute walk test distance increased by 52 ± 48 m (P = .001), peak treadmill cardiopulmonary exercise test time increased by 163 ± 130 s (P = .001), and time to achieve gas exchange threshold increased by 145 ± 37 s (P < .001). Despite a negligible increase in peak (Equation is included in full-text article.)o2 with no changes to cardiac output, the overall work rate/(Equation is included in full-text article.)o2 relationship was enhanced after training. Muscle O2 extraction increased by 16% (P = .049) after training.

CONCLUSIONS

Clinically significant improvements in cardiorespiratory function were observed after aerobic exercise training in this group of subjects with interstitial lung disease. These improvements appear to have been mediated by increases in the peripheral extraction of O2 rather than changes in O2 delivery.

摘要

目的

描述间质性肺疾病患者有氧运动训练前后运动时的心肺反应。

方法

我们进行了一项临床研究,对13例患者(纽约心脏协会/世界卫生组织功能分级为II级或III级)在接受为期10周的有监督的跑步机运动步行训练前后进行检查,运动强度为心率储备的70%至80%,每次运动30至45分钟,每周3次。观察指标包括跑步机心肺运动试验期间的心肺功能指标,以及外周氧摄取的近红外光谱测量和心输出量的生物阻抗心动图测量。还测量了6分钟步行试验距离。

结果

所有受试者均至少参加了30次预定训练课程中的24次,未发生明显不良事件。训练后,6分钟步行试验平均距离增加了52±48米(P = 0.001),跑步机心肺运动试验峰值时间增加了163±130秒(P = 0.001),达到气体交换阈值的时间增加了145±37秒(P < 0.001)。尽管峰值(全文包含公式)o2增加可忽略不计且心输出量无变化,但训练后总体工作率/(全文包含公式)o2关系得到增强。训练后肌肉氧摄取增加了16%(P = 0.049)。

结论

在这组间质性肺疾病患者中,有氧运动训练后观察到心肺功能有临床显著改善。这些改善似乎是由外周氧摄取增加介导的,而非氧输送的变化。

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