Alison J A, Regnis J A, Donnelly P M, Adams R D, Sullivan C E, Bye P T
Department of Respiratory Medicine, Royal Prince Alfred Hospital, Camperdown, 2050 NSW, Australia.
Am J Respir Crit Care Med. 1998 Nov;158(5 Pt 1):1450-8. doi: 10.1164/ajrccm.158.5.9710009.
There are no reports concerning the regulation of end-expiratory lung volume (EELV) and flow-volume relationships during upper limb exercise in health and disease. We studied EELV during such exercise in 22 adults with cystic fibrosis (CF) and nine age-matched healthy control subjects. Subjects with CF were grouped according to the severity of their lung disease, as follows: mild = FEV1 > 80% predicted; moderate = FEV1 40 to 80% predicted, and severe = FEV1 < 40% predicted. EELV was calculated from measurements of inspiratory capacity (IC) made at each workload during an incremental arm and leg ergometer test to peak work capacity. In the control group, the decrease in EELV was significantly smaller for arm than for leg exercise at peak work (-0.13 L versus -0.53 L, p < 0.001) and for arm than for leg exercise at an equivalent submaximal ventilation (-0.13 L versus -0.46 L, p < 0.01). In the groups with moderate and severe CF, arm exercise resulted in an increase in EELV from resting levels (dynamic hyperinflation) that was not significantly different from the increase observed for leg exercise. For CF subjects there was a significant inverse relationship between FEV1 and changes in EELV from rest to peak arm exercise (r = -0.46, p < 0.05). In normal subjects, there was a difference in the EELV response for arm versus leg exercise. In CF subjects with airflow limitation, dynamic hyperinflation occurred with both forms of exercise.
目前尚无关于健康和疾病状态下上肢运动期间呼气末肺容积（EELV）调节及流量-容积关系的报道。我们对22名成年囊性纤维化（CF）患者和9名年龄匹配的健康对照者在这种运动期间的EELV进行了研究。CF患者根据其肺部疾病严重程度分组如下：轻度=第1秒用力呼气容积（FEV1）>预测值的80%；中度=FEV1为预测值的40%至80%，重度=FEV1<预测值的40%。EELV通过在递增式手臂和腿部测力计测试至峰值工作能力期间，对每个工作负荷下的吸气容量（IC）测量值进行计算得出。在对照组中，在峰值工作时，手臂运动导致的EELV下降明显小于腿部运动（-0.13 L对-0.53 L，p<0.001），在同等次最大通气量时，手臂运动导致的EELV下降也小于腿部运动（-0.13 L对-0.46 L，p<0.01）。在中度和重度CF组中，手臂运动导致EELV从静息水平增加（动态肺过度充气），这与腿部运动时观察到的增加无显著差异。对于CF患者，FEV1与从静息到峰值手臂运动时EELV的变化之间存在显著的负相关（r=-0.46，p<0.05）。在正常受试者中，手臂运动和腿部运动的EELV反应存在差异。在有气流受限的CF患者中，两种运动形式均出现动态肺过度充气。
