重度阻塞性气道疾病患者运动时呼吸能力的改善。

Improved breathing capacity during exercise in severe obstructive airway disease.

作者信息

Natif N, Shiner R J, Gaides M, Ben-Dov I

机构信息

Sackler Medical School, Tel-Aviv University, Israel.

出版信息

Respir Physiol. 1998 May;112(2):145-54. doi: 10.1016/s0034-5687(98)00024-3.

DOI:10.1016/s0034-5687(98)00024-3

PMID:9716298

Abstract

In severe COPD, ventilation at peak exercise may exceed the resting maximal voluntary ventilation (MVV). We investigated the mechanisms by which the breathing capacity can improve during exercise in COPD. A total of 13 patients with an FEV1 of 32+/-12% (SD) predicted, performed an incremental maximal exercise test and FVC and MVV maneuvers at rest and during constant work rate exercise. Maximal exercise ventilation was 3+/-2 L/min higher than resting MVV. Breathing capacity improved during exercise; resting MVV was 30+/-3 (SE) L/min, while it reached 38+/-3 L/min during exercise (P < 0.002). FEV1 improved from 0.86+/-0.1 L at rest to 1.01+/-0.1 L during exercise (P < 0.004), which is consistent with exercise-induced bronchodilatation. It is concluded that in severe COPD, breathing capacity improves during exercise. Assuming that the change in FEV1 reflects improved airway function, these data suggest that exercise-induced bronchodilatation contributed to that improvement.

摘要

在重度慢性阻塞性肺疾病（COPD）中，运动峰值时的通气量可能超过静息时的最大自主通气量（MVV）。我们研究了COPD患者运动期间呼吸能力得以改善的机制。共有13例预计第一秒用力呼气容积（FEV1）为32±12%（标准差）的患者，进行了递增式最大运动试验，并在静息和恒定工作率运动期间进行了用力肺活量（FVC）和MVV操作。最大运动通气量比静息MVV高3±2升/分钟。运动期间呼吸能力有所改善；静息MVV为30±3（标准误）升/分钟，而运动期间达到38±3升/分钟（P<0.002）。FEV1从静息时的0.86±0.1升提高到运动期间的1.01±0.1升（P<0.004），这与运动诱发的支气管扩张一致。得出的结论是，在重度COPD中，运动期间呼吸能力会改善。假设FEV1的变化反映了气道功能的改善，这些数据表明运动诱发的支气管扩张促成了这种改善。