Ye R, Wu X J, Zhao L, Zhu L H, Wang C H, Gao Y Z, Wang Y
Department of Respiratory Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2019 Jan 12;42(1):20-23. doi: 10.3760/cma.j.issn.1001-0939.2019.01.007.
To evaluate the characteristics of exercise ventilation and gas exchange in obese and extremely obese patients by Cardiopulmonary exercise test (CPX). Restrospective anal-ysis of subjects who underwent CPET in Shengjing Hospital of China Medical University from June 2014 to June 2017. A total of 74 subjects were enrolled. According to the body mass index (BMI), 74 subjects were divided into control group(18.5 kg/m(2)≤BMI<23.9 kg/m(2)) (21), obese group (28.0 kg/m(2)≤BMI<40.0 kg/m(2)) (30) and extremely obese group(BMI≥40.0 kg/m(2))(23), respectively. V(O2max), V(O2max)/kg, anaerobic thresh-old(AT), oxygen pulse(V(O2)/HR), breath reserve(BR), inhale time (VTin), expiratory time(VTex) and ventilato-ry equivalent for CO(2)(EqCO(2))were measured by CPX and compared by using one-way ANOVA. Compared to the control group (1 620±400) L/min, the maximal oxygen uptake(V(O2max)) in obese group(1 905±592) L/min and extremely obese group (2 131.09±541.86) L/min were significance higher (5.14, 0.01). The V(O2max)/kg in obese group (19±5) L·min(-1)·kg(-1) and extremely obese groups (16±4) L·min(-1)·kg(-1) were sig-nificant lower than those in control group(27±5)L·min(-1)·kg(-1) (35.37,0.01). Compared to the control group (9.3±1.4)L·min(-1)·W(-1), the change of oxygen uptake required under certain exercise load (ΔV(O2)/ΔWR) in obese group(9.0±1.7) L·min(-1)·W(-1)and extremely obese group (8.7±2.2) L·min(-1)·W(-1) were no significant difference (0.67,0.51). The AT in obese group (1 114±391) L/min and extremely obese group (1 348±349) L/min were significant higher than those in control group (832±223) L/min (12.85,0.01). Com-pared to the control group(10±4) L·min(-1)·b(-1), V(O2)/HR in obese group (12±3) L·min(-1)·b(-1) and extremely obese group(14±3) L·min·b(-1) were significance higher (8.16, 0.01). No significant difference was found between the three groups in BR, VTin, VTex and EqCO(2). obese and extremely obese individu-als have a decreased ablity to exercise when the body requires anaerobic metabolism to provide energy. As exercise power increases, the heart oxygen consumption per stroke and the amount of volume and oxygen re-quired for gax exchange does increase.
通过心肺运动试验(CPX)评估肥胖和极度肥胖患者的运动通气和气体交换特征。对2014年6月至2017年6月在中国医科大学盛京医院接受心肺运动试验(CPET)的受试者进行回顾性分析。共纳入74名受试者。根据体重指数(BMI),将74名受试者分为对照组(18.5kg/m²≤BMI<23.9kg/m²)(21例)、肥胖组(28.0kg/m²≤BMI<40.0kg/m²)(30例)和极度肥胖组(BMI≥40.0kg/m²)(23例)。通过CPX测量最大摄氧量(V̇O₂max)、每千克体重最大摄氧量(V̇O₂max/kg)、无氧阈(AT)、氧脉搏(V̇O₂/HR)、呼吸储备(BR)、吸气时间(VTin)、呼气时间(VTex)和二氧化碳通气当量(EqCO₂),并采用单因素方差分析进行比较。与对照组(1620±400)L/min相比,肥胖组(1905±592)L/min和极度肥胖组(2131.09±541.86)L/min的最大摄氧量(V̇O₂max)显著更高(F=5.14,P=0.01)。肥胖组(19±5)L·min⁻¹·kg⁻¹和极度肥胖组(16±4)L·min⁻¹·kg⁻¹的每千克体重最大摄氧量(V̇O₂max/kg)显著低于对照组(27±5)L·min⁻¹·kg⁻¹(F=35.37,P=0.01)。与对照组(9.3±1.4)L·min⁻¹·W⁻¹相比,肥胖组(9.0±1.7)L·min⁻¹·W⁻¹和极度肥胖组(8.7±2.2)L·min⁻¹·W⁻¹在一定运动负荷下所需摄氧量的变化(ΔV̇O₂/ΔWR)无显著差异(F=0.67,P=0.51)。肥胖组(1114±391)L/min和极度肥胖组(1348±349)L/min的无氧阈(AT)显著高于对照组(832±223)L/min(F=12.85,P=0.01)。与对照组(10±4)L·min⁻¹·b⁻¹相比,肥胖组(12±3)L·min⁻¹·b⁻¹和极度肥胖组(14±3)L·min⁻¹·b⁻¹的氧脉搏(V̇O₂/HR)显著更高(F=8.16,P=0.01)。三组在呼吸储备(BR)、吸气时间(VTin)、呼气时间(VTex)和二氧化碳通气当量(EqCO₂)方面无显著差异。肥胖和极度肥胖个体在身体需要无氧代谢提供能量时运动能力下降。随着运动功率增加,每搏心脏耗氧量以及气体交换所需的容积和氧量确实会增加。