Department of Respiratory Medicine, "G. Papanikolaou" Hospital, Thessaloniki, Greece.
Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Serres, Greece.
Clin Physiol Funct Imaging. 2020 Jul;40(4):197-206. doi: 10.1111/cpf.12627. Epub 2020 Apr 2.
Chronic obstructive pulmonary disease is a debilitating disorder, characterized by airflow limitation, exercise impairment, reduced functional capacity and significant systemic comorbidity, which complicates the course of the disease. The critical inspiratory constraint to tidal volume expansion during exercise (that may be further complicated by the presence of dynamic hyperinflation), abnormalities in oxygen transportation and gas exchange abnormalities are the major pathophysiological mechanisms of exercise intolerance in COPD patients, and thus, exercise testing has been traditionally used for the functional evaluation of these patients. Compared to various laboratory and field exercise tests, cardiopulmonary exercise testing (CPET) provides a thorough assessment of exercise physiology, involving the integrative respiratory, cardiovascular, muscle and metabolic responses to exercise. This review highlights the clinical utility of CPET in COPD patients, as it provides important information for the determination of the major factors that limit exercise among patients with several comorbidities, allows the assessment of the severity of dynamic hyperinflation, provides valuable prognostic information and can be used to evaluate the response to several therapeutic interventions.
慢性阻塞性肺疾病是一种使人虚弱的疾病，其特征是气流受限、运动能力受损、功能能力降低和严重的全身性合并症，这使疾病的进程复杂化。运动时潮气量扩张的关键吸气限制（可能因动态过度充气的存在而变得更加复杂）、氧运输异常和气体交换异常是 COPD 患者运动不耐受的主要病理生理机制，因此，运动测试一直被传统用于这些患者的功能评估。与各种实验室和现场运动测试相比，心肺运动测试（CPET）提供了对运动生理学的全面评估，涉及呼吸、心血管、肌肉和代谢对运动的综合反应。这篇综述强调了 CPET 在 COPD 患者中的临床应用，因为它为确定患有多种合并症的患者运动受限的主要因素提供了重要信息，允许评估动态过度充气的严重程度，提供有价值的预后信息，并可用于评估对几种治疗干预的反应。
