Iwanaga T, Hirai M, Ikeda T, Kishikawa R, Yamato H, Inatsu K, Fukuda M, Nogami Y, Yokota K, Tsurutani H
Section of Pulmonary Medicine, National Minami-Fukuoka Chest Hospital.
Nihon Kyobu Shikkan Gakkai Zasshi. 1994 Dec;32 Suppl:127-34.
The pattern of change in arterial oxyhemoglobin saturation (SpO2) measured by pulse oximetry (PO) during exercise, including daily activities, was studied in 23 patients with interstitial lung disease (ILD), 19 of whom had idiopathic pulmonary fibrosis, 3 collagen vascular disease, and 1 BOOP. Hypoxemia, as detected by PO appeared without dyspnea at the beginning of exertion or at a mild workload. Exercise usually induced significant changes in the same fashion first in heart rate, then in SpO2, and then in dyspnea, but stair climbing had a different pattern. Workload at the lactate threshold (LT) and symptom-limited maximal exercise (SL) in a bicyclergometer incremental exercise test correlated well with distance walked in a 10-minute walking test (10-eMD) (p < 0.01). Similarly, the degree in desaturation in each exercise test was closely correlated (p < 0.01). Exertional hypoxemia was more prominent in patients with ILD than in those with chronic pulmonary emphysema. Nevertheless, dyspne changed less per change in SpO2 in ILD patients. We conclude that prolonged monitoring of SpO2 by PO will disclose the presence of exertional desaturation in ILD patients.
我们对23例间质性肺疾病(ILD)患者在运动(包括日常活动)期间通过脉搏血氧饱和度仪(PO)测量的动脉血氧血红蛋白饱和度(SpO2)的变化模式进行了研究,其中19例患有特发性肺纤维化,3例患有胶原血管疾病,1例患有闭塞性细支气管炎伴机化性肺炎(BOOP)。通过PO检测到的低氧血症在运动开始时或轻度负荷时无呼吸困难表现。运动通常首先以相同方式引起心率的显著变化,然后是SpO2,接着是呼吸困难,但爬楼梯有不同的模式。在自行车测力计递增运动试验中,乳酸阈值(LT)和症状限制最大运动(SL)时的负荷与10分钟步行试验(10-eMD)中的步行距离相关性良好(p < 0.01)。同样,每次运动试验中的去饱和程度密切相关(p < 0.01)。与慢性肺气肿患者相比,ILD患者运动性低氧血症更为突出。然而,ILD患者中SpO2每变化一次,呼吸困难的变化较小。我们得出结论,通过PO对SpO2进行长期监测将揭示ILD患者存在运动性去饱和。