Chlif Mehdi, Temfemo Abdou, Keochkerian David, Choquet Dominique, Chaouachi Anis, Ahmaidi Said
Sport Science Department, Picardie Jules Verne University, F-80025 Amiens Cedex, France Tunisian Research Laboratory Sport Performance Optimization, National Center of Medicine and Science in Sports, Tunis, Tunisia
Sport Science Department, Picardie Jules Verne University, F-80025 Amiens Cedex, France.
Respir Care. 2015 Apr;60(4):549-60. doi: 10.4187/respcare.03206. Epub 2015 Jan 27.
We investigated the role of mechanical ventilatory constraints in obese class III subjects during incremental exercise.
We examined 14 control subjects (body mass index [BMI], 23.6 ± 3.2 kg/m(2)), 15 obese class II subjects (BMI, 37.2 ± 4.5 kg/m(2)), and 17 obese class III subjects (BMI, 53.4 ± 6.8 kg/m(2)). All subjects performed pulmonary function tests and maximal inspiratory pressure at rest, ventilatory parameters, flow-volume loops, and rated perceived exertion and breathlessness during exercise.
All subjects had normal pulmonary function. Obesity resulted in increased minute ventilation for a given submaximal work rate, although minute ventilation during peak exercise was lowest in the obese class III subjects. End-expiratory lung volume was significantly lower in the obese subjects at rest and during exercise at the ventilatory threshold but not during peak exercise. During heavy-to-peak exercise, the obese subjects increased their end-expiratory lung volume, whereas the control group continued to decrease this parameter. Compared with controls, end-inspiratory lung volume was significantly lower in obese class II subjects and obese class III subjects at rest and at the ventilatory threshold but not during peak exercise. At maximal exercise, obese class III subjects had a greater end-inspiratory lung volume than obese class II subjects and controls. Obese class III subjects displayed a greater expiratory air flow limitation at rest, at the ventilatory threshold, and during peak exercise than both controls and obese class II subjects.
Mechanical ventilatory constraints increase progressively with degrees of obesity, contributing to exercise limitation in obese subjects.
我们研究了递增运动期间机械通气限制在III级肥胖受试者中的作用。
我们检查了14名对照受试者（体重指数[BMI]，23.6±3.2kg/m²）、15名II级肥胖受试者（BMI，37.2±4.5kg/m²）和17名III级肥胖受试者（BMI，53.4±6.8kg/m²）。所有受试者均进行了肺功能测试、静息时的最大吸气压、通气参数、流量-容积环以及运动期间的主观用力感觉和呼吸困难程度评估。
所有受试者的肺功能均正常。肥胖导致在给定的次最大工作率下分钟通气量增加，尽管III级肥胖受试者在运动峰值时的分钟通气量最低。肥胖受试者在静息时和通气阈值运动时的呼气末肺容积显著降低，但在运动峰值时无此现象。在重度至峰值运动期间，肥胖受试者增加了呼气末肺容积，而对照组则继续降低该参数。与对照组相比，II级肥胖受试者和III级肥胖受试者在静息时和通气阈值时的吸气末肺容积显著降低，但在运动峰值时无此现象。在最大运动时，III级肥胖受试者的吸气末肺容积大于II级肥胖受试者和对照组。III级肥胖受试者在静息时、通气阈值时和运动峰值时的呼气气流受限程度均大于对照组和II级肥胖受试者。
机械通气限制随肥胖程度逐渐增加，导致肥胖受试者运动受限。
