McClaran S R, Harms C A, Pegelow D F, Dempsey J A
John Rankin Laboratory of Pulmonary Medicine, Department of Preventive Medicine, University of Wisconsin-Madison, Madison, Wisconsin 53705, USA.
J Appl Physiol (1985). 1998 Jun;84(6):1872-81. doi: 10.1152/jappl.1998.84.6.1872.
We subjected 29 healthy young women (age: 27 +/- 1 yr) with a wide range of fitness levels [maximal oxygen uptake (VO2 max): 57 +/- 6 ml . kg-1 . min-1; 35-70 ml . kg-1 . min-1] to a progressive treadmill running test. Our subjects had significantly smaller lung volumes and lower maximal expiratory flow rates, irrespective of fitness level, compared with predicted values for age- and height-matched men. The higher maximal workload in highly fit (VO2 max > 57 ml . kg-1 . min-1, n = 14) vs. less-fit (VO2 max < 56 ml . kg-1 . min-1, n = 15) women caused a higher maximal ventilation (VE) with increased tidal volume (VT) and breathing frequency (fb) at comparable maximal VT/vital capacity (VC). More expiratory flow limitation (EFL; 22 +/- 4% of VT) was also observed during heavy exercise in highly fit vs. less-fit women, causing higher end-expiratory and end-inspiratory lung volumes and greater usage of their maximum available ventilatory reserves. HeO2 (79% He-21% O2) vs. room air exercise trials were compared (with screens added to equalize external apparatus resistance). HeO2 increased maximal expiratory flow rates (20-38%) throughout the range of VC, which significantly reduced EFL during heavy exercise. When EFL was reduced with HeO2, VT, fb, and VE (+16 +/- 2 l/min) were significantly increased during maximal exercise. However, in the absence of EFL (during room air exercise), HeO2 had no effect on VE. We conclude that smaller lung volumes and maximal flow rates for women in general, and especially highly fit women, caused increased prevalence of EFL during heavy exercise, a relative hyperinflation, an increased reliance on fb, and a greater encroachment on the ventilatory "reserve." Consequently, VT and VE are mechanically constrained during maximal exercise in many fit women because the demand for high expiratory flow rates encroaches on the airways' maximum flow-volume envelope.
我们让29名健康年轻女性(年龄:27±1岁)进行递增式跑步机跑步测试,她们的体能水平差异较大[最大摄氧量(VO2 max):57±6 ml·kg-1·min-1;35 - 70 ml·kg-1·min-1]。与年龄和身高匹配的男性预测值相比,无论体能水平如何,我们的受试者肺容积明显较小,最大呼气流量率较低。与体能较差的女性(VO2 max < 56 ml·kg-1·min-1,n = 15)相比,体能较好的女性(VO2 max > 57 ml·kg-1·min-1,n = 14)在更高的最大工作量下,在可比的最大潮气量/肺活量(VT/VC)时,会导致更高的最大通气量(VE),潮气量(VT)和呼吸频率(fb)增加。在剧烈运动中,体能较好的女性比体能较差的女性观察到更多的呼气流量限制(EFL;占VT的22±4%),导致更高的呼气末和吸气末肺容积以及更大程度地动用其最大可用通气储备。比较了氦氧混合气(79% He - 21% O2)与室内空气运动试验(添加滤网以平衡外部器械阻力)。氦氧混合气在整个VC范围内增加了最大呼气流量率(20 - 38%),这在剧烈运动期间显著降低了EFL。当用氦氧混合气降低EFL时,在最大运动期间VT、fb和VE(+16±2 l/min)显著增加。然而,在没有EFL的情况下(在室内空气运动期间),氦氧混合气对VE没有影响。我们得出结论,一般女性,尤其是体能较好的女性,肺容积较小和最大流量率较低,导致在剧烈运动期间EFL的患病率增加、相对肺过度充气、对fb的依赖增加以及对通气“储备”的更大侵犯。因此,在许多体能良好的女性进行最大运动时,VT和VE受到机械限制,因为对高呼气流量率的需求侵犯了气道的最大流量-容积包络线。