Samet J M, Lambert W E, James D S, Mermier C M, Chick T W
New Mexico Tumor Registry, University of New Mexico Medical Center, Albuquerque 87131-5306.
Res Rep Health Eff Inst. 1993 May(59):19-55; discussion 57-69.
The rate of ventilation and route of breathing (i.e., nasal versus oronasal) are potential determinants of pollutant doses to target sites in the lung. However, the lack of accurate methods for ambulatory measurement of ventilation has hindered estimation of exposure and dose in freely ranging individuals, complicating the interpretation of the relationships among exposure, dose, and response in epidemiological studies. The goal of this project was to develop and validate a method of monitoring ventilation for large-scale epidemiologic investigations. We estimated ventilation for individual subjects from ambulatory heart rate monitoring, using the relationship between ventilation and heart rate that had been obtained during exercise testing. Fifty-eight subjects participated in the study, which included healthy adults and children, and subjects with lung and heart disease. Subjects performed cycle exercise and tasks involving lifting and vacuuming. Work loads of progressive and variable order were used in the testing. Conventional methods were used to measure heart rate and total ventilation, and a sampling mask was developed to measure the partitioning of breathing between oral and nasal routes. The minute ventilation-heart rate relation was evaluated under steady-state and varying work loads. In a second phase, subjects wore wristwatch monitors that recorded their heart rates, minute by minute, throughout the day. Subjects recorded activities, locations, and levels of exertion. Two 16-hour monitoring periods were obtained from each subject. The laboratory findings documented considerable intersubject variability in the minute ventilation-heart rate relation with a two- to five-fold range in the coefficients describing the change in ventilation relative to heart rate. This variation implies that individual testing is required to derive accurate predictive equations. Minute ventilation-heart rate regressions for the maximal progressive exercise test and for the test with a nonprogressive submaximal work load sequence were comparable, indicating that varying the sequence of work loads does not substantially affect the minute ventilation-to-heart rate ratio. During upper body work (e.g., lifting), the minute ventilation-to-heart rate ratio was one-third greater than during lower body exercise. Diverse patterns of partitioning breathing between oral and nasal routes were observed with increasing oral ventilation in most subjects as work load increased. In the field, heart rate and activity patterns were monitored successfully in adults and children with low rates of instrument failure and noncompliance.(ABSTRACT TRUNCATED AT 400 WORDS)
通气速率和呼吸途径(即经鼻呼吸与经口鼻呼吸)是肺部靶位点污染物剂量的潜在决定因素。然而,缺乏用于动态测量通气的准确方法阻碍了对自由活动个体的暴露和剂量估计,使得在流行病学研究中对暴露、剂量和反应之间关系的解读变得复杂。本项目的目标是开发并验证一种用于大规模流行病学调查的通气监测方法。我们利用运动测试中获得的通气与心率之间的关系,通过动态心率监测来估计个体受试者的通气情况。58名受试者参与了该研究,包括健康的成年人和儿童以及患有肺部和心脏疾病的受试者。受试者进行了自行车运动以及涉及举重和吸尘的任务。测试中采用了递增和可变顺序的工作负荷。使用传统方法测量心率和总通气量,并开发了一个采样面罩来测量经口和经鼻呼吸途径之间的分配情况。在稳态和变化的工作负荷下评估分钟通气量与心率的关系。在第二阶段,受试者佩戴腕式监测仪,全天每分钟记录他们的心率。受试者记录活动、地点和用力程度。从每个受试者获得两个16小时的监测期。实验室研究结果表明,受试者之间分钟通气量与心率关系存在相当大的变异性,描述通气相对于心率变化的系数范围为2至5倍。这种变异性意味着需要进行个体测试才能得出准确的预测方程。最大递增运动测试和非递增次最大工作负荷序列测试的分钟通气量与心率回归结果具有可比性,表明改变工作负荷序列不会显著影响分钟通气量与心率比值。在上半身工作(如举重)期间,分钟通气量与心率比值比下半身运动时大三分之一。随着工作负荷增加,大多数受试者经口通气增加,观察到经口和经鼻呼吸途径之间不同的呼吸分配模式。在实地,成功监测了成人和儿童的心率和活动模式,仪器故障和不依从率较低。(摘要截选至400字)