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预测慢性阻塞性肺疾病患者的最大运动通气量。

Predicting maximal exercise ventilation in patients with chronic obstructive pulmonary disease.

作者信息

Carter R, Peavler M, Zinkgraf S, Williams J, Fields S

出版信息

Chest. 1987 Aug;92(2):253-9. doi: 10.1378/chest.92.2.253.

Abstract

Shortness of breath is a chief complaint of many individuals with cardiopulmonary diseases. Exercise testing is often used to help differentiate cardiac from pulmonary involvement. In assessing pulmonary dysfunction during exercise it is essential to know the point at which ventilatory limitation will occur. Numerous authors have presented regression equations based on the FEV1 for predicting either MVV or VEmax. Resting pulmonary function studies were obtained from 53 patients with COPD. Symptom-limited maximal exercise testing was completed on a cycle ergometer using increments of 10 watts/min. Each regression equation for predicting MVV or VEmax was then applied to the data set. Results showed that the FEV1 correlated with the measured VEmax (r = .81) as did PEF (r = .81), MVV (r = .78), IC (r = .78), DCO (r = .68), VA (r = .67), VE (r = .65) and FVC (r = .64). Single post-bronchodilator FEV1 measurements ranged from 0.56 to 1.64 L (mean 1.0 L) while VEmax ranged from 16 to 78 L/min (mean 37.69 L/min). The equation VEmax = 37.5 X FEV1 was the most robust equation found in the literature for predicting VEmax in this sample. This equation was not statistically different from the line of identity when predicted VEmax was plotted against the measured VEmax. The intercept was 0.91 with a slope of 0.98. In addition, this equation had a smaller mean square error in predicting VEmax than those of the other equations investigated.

摘要

呼吸急促是许多心肺疾病患者的主要症状。运动测试常用于帮助区分心脏和肺部受累情况。在评估运动期间的肺功能障碍时,了解通气受限发生的点至关重要。许多作者提出了基于第一秒用力呼气容积(FEV1)的回归方程,用于预测最大自主通气量(MVV)或最大通气量(VEmax)。对53例慢性阻塞性肺疾病(COPD)患者进行了静息肺功能研究。使用每分钟10瓦的增量在功率自行车上完成症状限制性最大运动测试。然后将每个预测MVV或VEmax的回归方程应用于数据集。结果显示,FEV1与测量的VEmax相关(r = 0.81),呼气峰值流速(PEF)(r = 0.81)、MVV(r = 0.78)、吸气量(IC)(r = 0.78)、一氧化碳弥散量(DCO)(r = 0.68)、肺泡通气量(VA)(r = 0.67)、分钟通气量(VE)(r = 0.65)和用力肺活量(FVC)(r = 0.64)也相关。支气管扩张剂使用后单次FEV1测量值范围为0.56至1.64升(平均1.0升),而VEmax范围为16至78升/分钟(平均37.69升/分钟)。方程VEmax = 37.5×FEV1是文献中发现的用于预测该样本中VEmax的最稳健方程。当将预测的VEmax与测量的VEmax绘制在一起时,该方程与恒等线在统计学上无差异。截距为0.9(此处原文可能有误,按照前文推测应为0.91),斜率为0.98。此外,该方程在预测VEmax时的均方误差比所研究的其他方程更小。

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