Bellone A, Frisinghelli A, Pozzi G, Lapidari G, Carnovali M
Dept of Respiratory Medicine, Ospedale di Passirana, Rho (Milano), Italy.
Monaldi Arch Chest Dis. 1996 Apr;51(2):117-9.
To investigate gas exchange response to exercise, we studied 16 male patients with moderate-to-serve airflow obstruction (forced expiratory volume in one second (FEV1) 39 +/- 10% of predicted value), mild-modest arterial hypoxaemia (arterial oxygen tension (Pa,O2) 9.6 +/- 0.87 kPa) and no arterial hypercapnia (arterial carbon dioxide tension (Pa,CO2) 5.04 +/- 0.45 kPa), referred to as emphysematous-type chronic obstructive pulmonary disease (COPD) clinical pattern. During maximal exercise tests, Pa,O2 increased by more than 0.3 kPa in eight patients (Group A) and fell by more than 0.3 kPa in the other eight patients (Group B). Pulmonary function tests, maximal inspiratory pressure at the mouth, values at maximum cycle incremental exercise and baseline arterial blood gases did not differ significantly between the two groups. We, therefore, showed that common pulmonary function measurements at rest and during exercise were not useful in identifying patients who underwent exercise-induced hypoxaemia. Furthermore, we suggest that patients with the same clinical pattern of chronic obstructive pulmonary disease and the same degree of airflow obstruction and gas exchange impairment could develop a different adaptation to a maximal exercise test, and that the presence of exercise-induced hypoxaemia might be related to pathological features of emphysema more than to different respiratory functional measurements.
为研究运动时的气体交换反应，我们对16例男性患者进行了研究，这些患者患有中度至重度气流阻塞（一秒用力呼气容积（FEV1）为预测值的39±10%）、轻度至中度动脉血氧不足（动脉血氧分压（Pa,O2）为9.6±0.87 kPa）且无动脉血二氧化碳潴留（动脉血二氧化碳分压（Pa,CO2）为5.04±0.45 kPa），此为肺气肿型慢性阻塞性肺疾病（COPD）临床类型。在最大运动试验期间，8例患者（A组）的Pa,O2升高超过0.3 kPa，另外8例患者（B组）的Pa,O2下降超过0.3 kPa。两组之间的肺功能测试、口腔最大吸气压力、最大循环递增运动时的值以及基线动脉血气无显著差异。因此，我们表明，静息和运动时的常见肺功能测量对于识别运动诱发低氧血症患者并无用处。此外，我们认为，具有相同慢性阻塞性肺疾病临床类型、相同程度气流阻塞和气体交换损害的患者对最大运动试验可能会产生不同的适应性，并且运动诱发低氧血症的存在可能与肺气肿的病理特征有关，而不仅仅与不同的呼吸功能测量有关。
