肺动脉高压对慢性阻塞性肺疾病患者运动能力的影响。
Effects of Pulmonary Hypertension on Exercise Capacity in Patients With Chronic Obstructive Pulmonary Disease.
机构信息
Department of Pulmonary Medicine, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain.
Department of Pulmonary Medicine, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
出版信息
Arch Bronconeumol (Engl Ed). 2020 Aug;56(8):499-505. doi: 10.1016/j.arbres.2019.10.015. Epub 2019 Nov 23.
INTRODUCTION
The impact of pulmonary hypertension (PH) on exercise tolerance in chronic obstructive pulmonary disease (COPD) has not been fully elucidated. It is necessary to characterize pulmonary hemodynamics in patients with moderate to severe COPD in order to improve their management. The aim of the study was to determine whether in COPD the presence of PH is associated with reduced exercise tolerance in a cohort of stable COPD patients.
METHODS
Cross-sectional analysis of 174 COPD patients clinically stable: 109 without PH and 65 with PH (COPD-PH). We assessed socio-demographic data, lung function, quality of life, dyspnea, cardiopulmonary exercise testing (CPET), constant workload endurance time (CWET), and six-minute walk test (6MWT). We elaborated a logistic regression model to explore the impact of PH on exercise capacity in COPD patients.
RESULTS
COPD-PH patients showed lower exercise capacity both at maximal (CPET) (43(20) versus 68(27) Watts and 50(19)% versus 71(18)% predicted peak oxygen consumption (VOpeak), COPD-PH and COPD, respectively), and at submaximal tests (6MWT) (382(94) versus 486(95) m). In addition, the COPD-PH group had lower endurance time than the non-PH COPD group (265(113) s and 295(164) s, respectively).
CONCLUSIONS
The presence of PH is an independent factor that impairs exercise capacity in COPD.
简介
肺动脉高压（PH）对慢性阻塞性肺疾病（COPD）患者运动耐量的影响尚未完全阐明。为了改善 COPD 患者的管理，有必要对中重度 COPD 患者的肺血流动力学进行特征描述。本研究的目的是确定在 COPD 患者中，PH 的存在是否与稳定期 COPD 患者运动耐力下降有关。
方法
对 174 例临床稳定的 COPD 患者进行横断面分析：109 例无 PH（COPD 组）和 65 例有 PH（COPD-PH 组）。我们评估了社会人口统计学数据、肺功能、生活质量、呼吸困难、心肺运动试验（CPET）、恒定负荷耐力时间（CWET）和 6 分钟步行试验（6MWT）。我们建立了一个逻辑回归模型来探讨 PH 对 COPD 患者运动能力的影响。
结果
COPD-PH 患者的运动能力在最大运动测试（CPET）（43（20）与 68（27）瓦特和 50（19）%与 71（18）%预测峰值摄氧量（VOpeak），分别为 COPD-PH 和 COPD）和亚最大运动测试（6MWT）（382（94）与 486（95）米）均较低。此外，COPD-PH 组的耐力时间短于非 PH COPD 组（分别为 265（113）秒和 295（164）秒）。
结论
PH 的存在是影响 COPD 患者运动能力的独立因素。
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