Takahashi H, Fujimoto K, Yoshikawa S, Matsuzawa Y, Kubo K, Kobayashi T, Sekiguchi M
First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1996 Jun;34(6):671-7.
We examined relationships among the distance walked in 10 minutes (10 MD), pulmonary function, and pulmonary hemodynamics during exercise on a bicycle ergometer, in patients with chronic pulmonary emphysema who had dyspnea of grade III to IV on the Hugh-Jones scale. The 10 MD did not correlate significantly with desaturation during the 10-minute walk, but it did correlate significantly with the percent of predicted maximum voluntary ventilation, and it correlated negatively with airway resistance. These findings indicate that ventilatory impairment is an important factor limiting 10 MD in these patients. Also 10 MD correlated significantly and positively with %DLco; and it correlated negatively with the index of pulmonary vascular resistance and with the ratio of the change in pulmonary arterial pressure to the change in cardiac index during exercise. (delta Ppa/delta CI). These findings indicate that impairment of pulmonary circulation may also limit the 10 MD and exercise tolerance in patients with chronic pulmonary emphysema.
我们研究了重度(III至IV级)慢性肺气肿且有呼吸困难症状的患者在自行车测力计上运动期间10分钟步行距离(10 MD)、肺功能和肺血流动力学之间的关系。10 MD与10分钟步行期间的血氧饱和度下降无显著相关性,但与预计最大自主通气量百分比显著相关,且与气道阻力呈负相关。这些发现表明,通气功能障碍是限制这些患者10 MD的重要因素。此外,10 MD与一氧化碳弥散量百分比(%DLco)显著正相关;与肺血管阻力指数以及运动期间肺动脉压变化与心指数变化之比(δPpa/δCI)呈负相关。这些发现表明,肺循环障碍也可能限制慢性肺气肿患者的10 MD和运动耐力。