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慢性阻塞性肺疾病患者6分钟步行试验后的氧摄取恢复动力学

Oxygen Uptake Recovery Kinetics after the 6-Minute Walk Test in Patients with Chronic Obstructive Pulmonary Disease.

作者信息

Baty Florent, van Gestel Arnoldus J R, Kern Lukas, Brutsche Martin H

机构信息

Department of Pulmonary Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

出版信息

Respiration. 2016;92(6):371-379. doi: 10.1159/000452307. Epub 2016 Nov 9.

Abstract

BACKGROUND

There is a growing interest in exercise parameters capable of objectively evaluating the functional capacity of patients with chronic obstructive pulmonary disease (COPD).

OBJECTIVES

The purpose of the present study was to analyze breath-by-breath cardiopulmonary and gas exchange recovery responses of patients with COPD after a 6-minute walk test (6MWT).

METHODS

Oxygen uptake (VO2) kinetics of patients were obtained using mobile telemetric cardiopulmonary monitoring during and after a 6MWT. Recovery kinetics were modelled using a 4-parameter nonlinear logistic model. Multiple linear regression was performed to assess the association between the half-time of recovery of oxygen consumption (T1/2 VO2) and exercise capacity (6-minute walking distance, 6MWD).

RESULTS

Sixty-nine patients with COPD (28 females) with a mean age of 65 ± 10 years took part in the study. After adjustment for covariates (body mass index, forced expiratory volume in 1 s, forced vital capacity, and age), T1/2 VO2 was significantly associated with 6MWD (p = 0.002).

CONCLUSIONS

T1/2 VO2 can be used to reflect exercise capacity in patients with COPD. As T1/2 VO2 mostly depends on the rate of increase in pulmonary blood flow, the results of the present study underline the importance of cardiocirculatory impairment for exercise intolerance in patients with COPD.

摘要

背景

人们对能够客观评估慢性阻塞性肺疾病(COPD)患者功能能力的运动参数的兴趣日益浓厚。

目的

本研究的目的是分析COPD患者在6分钟步行试验(6MWT)后逐次呼吸的心肺和气体交换恢复反应。

方法

在6MWT期间及之后,使用移动遥测心肺监测获取患者的摄氧量(VO2)动力学。使用四参数非线性逻辑模型对恢复动力学进行建模。进行多元线性回归以评估耗氧量恢复半衰期(T1/2 VO2)与运动能力(6分钟步行距离,6MWD)之间的关联。

结果

69例COPD患者(28例女性)参与了研究,平均年龄为65±10岁。在对协变量(体重指数、第1秒用力呼气量、用力肺活量和年龄)进行调整后,T1/2 VO2与6MWD显著相关(p = 0.002)。

结论

T1/2 VO2可用于反映COPD患者的运动能力。由于T1/2 VO2主要取决于肺血流量的增加速率,本研究结果强调了心脏循环功能障碍对COPD患者运动不耐受的重要性。

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