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支气管哮喘患儿对体育锻炼的心肺反应。

Cardiorespiratory response to physical conditioning in children with bronchial asthma.

作者信息

Ramazanoglu Y M, Kraemer R

出版信息

Pediatr Pulmonol. 1985 Sep-Oct;1(5):272-7. doi: 10.1002/ppul.1950010510.

Abstract

The relationship of physical conditioning to changes in static lung volumes (hyperinflation) and airway dynamics (bronchoconstriction) as well as to ventilatory gas exchange, heart rate reserve, breathing reserves, and working capacity at a heart rate of 170/min (WC 170) was evaluated in 23 children (16 girls, 7 boys) between 6 and 15 years of age who had perennial asthma. Lung function tests including incremental cycle ergooxymetry were performed before and after a 15-week period of regular physical training (RPT). Lung function data obtained after RPT showed a significant improvement (P less than 0.05) in both hyperinflation and specific airway conductance, whereas oxygen consumption only increased related to lean body mass and heart rate. However, WC 170 and work tolerance during the endurance phase of the exercise test were significantly increased (P less than 0.05 and less than 0.01, respectively). In view of the relationship that has recently been found between exercise tolerance and lung mechanics in adults, the decreased hyperinflation and bronchoconstriction observed in our population after RPT is striking. This finding was presumably a consequence of the effect of RPT on breathing technique and chest wall mechanics. Ventilation of the lungs may improve because of mobilization of the costovertebral articulations, inspiratory muscle relaxation, an optimized force-length relationship of the respiratory muscles, and closer linkage between the diaphragm and intercostal muscles. Therefore, RPT might be an effective addition to standard drug regimens in the management of childhood asthma.

摘要

对23名6至15岁患有常年性哮喘的儿童(16名女孩,7名男孩)进行了评估,以研究体能状况与静态肺容积变化(肺过度充气)、气道动力学(支气管收缩)以及与通气气体交换、心率储备、呼吸储备和心率为170次/分钟时的工作能力(WC 170)之间的关系。在为期15周的常规体育训练(RPT)前后,进行了包括递增式循环运动心肺功能测试在内的肺功能测试。RPT后获得的肺功能数据显示,肺过度充气和比气道传导率均有显著改善(P<0.05),而耗氧量仅与瘦体重和心率相关增加。然而,运动测试耐力阶段的WC 170和工作耐力显著增加(分别为P<0.05和P<0.01)。鉴于最近在成年人中发现运动耐力与肺力学之间的关系,我们研究人群在RPT后观察到的肺过度充气和支气管收缩的减轻令人瞩目。这一发现可能是RPT对呼吸技术和胸壁力学产生影响的结果。肺通气可能因肋椎关节的活动、吸气肌的放松、呼吸肌最佳的力-长度关系以及膈肌与肋间肌之间更紧密的联系而得到改善。因此,RPT可能是儿童哮喘管理中标准药物治疗方案的有效补充。

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