慢性阻塞性肺疾病患者恒定功率运动时摄氧动力学改变及其影响因素  

Changes and influencing factors of oxygen uptake kinetics under constant work rate exercise in patients with chronic obstructive pulmonary disease

作　　者：颜恒毅[1] 赵立[1] 杨淑芹[1] 朱丽华[1] 

机构地区：[1]中国医科大学附属盛京医院呼吸内科,辽宁沈阳110004

出　　处：《中国医科大学学报》2007年第5期600-603,共4页Journal of China Medical University

摘　　要：目的:探讨慢性阻塞性肺疾病(COPD)患者在低于无氧阈的恒定功率运动时是否存在摄氧动力学延迟,讨论影响摄氧动力和完成恒定功率所增加摄氧量的相关因素。方法:16例COPD患者和19名健康对照者完成50W恒定功率运动实验,计算开始运动到稳定状态期间的平均反应时间(MRT)、氧赤字(O2deficit)、静息状态摄氧量(Vo2rest)、稳定状态摄氧量(Vo2stea)和稳态-静息摄氧量差(ΔVo2)、静息到稳态累计增加摄氧量(ΣΔVo2)和单位摄氧量完成功率(W/ΣΔVo2)。用Pearson相关分析影响摄氧动力和完成恒定功率所增加摄氧量的相关因素。结果:COPD组O2deficit、MRT和ΣΔVo2显著高于健康对照组。W/ΣΔVo2、Vo2rest、VO2stea和ΔVo2无显著差别。MRT和O2deficit显著正相关,和1秒用力呼气量(FEV1)、1秒用力呼气量占预计值百分比(FEV1.0%)、1秒用力呼气量与用力肺活量比值(FEV1/FVC)、W/ΣΔVo2、运动中血氧饱和度(SpO2exer)、Vo2rest和Vo2stea显著负相关;ΣΔVo2和O2deficit、ΔVo2、Vo2stea正相关,和FEV1/FVC显著负相关。结论:COPD患者存在摄氧动力障碍和高氧耗状态,摄氧动力障碍可能和气流受限、运动肌肉氧化代谢效能降低和低氧血症有关,是COPD患者运动耐力降低的可能负影响和机制。Objective：To explore whether the delay in oxygen uptake kinetics exists in patients with chronic obstructive pulmonary disease （COPD） under constant work rate exercise, and to study the factors affecting oxygen uptake kinetics. Methods：A total of 16 COPD patients and 19 healthy control subjects underwent 50 W constant workload exercise. The mean response time （MRT）, oxygen deficit, resting oxygen uptake （Vo2rest）, steady-state oxygen uptake （Vo2stea）, difference between resting and steady-state oxygen uptake （△Vo2）, accumulation of increased oxygen uptake from resting to steady state （∑△Vo2）, and oxygen cost of work （W/∑△Vo2） were calculated. The factors affecting the oxygen uptake kinetics and the accumulation of increased oxygen uptake were analyzed by using Pearson correlation. Results：The MRT, oxygen deficit, and ∑△Vo2 in COPD patients were significantly higher than those in healthy control subjects. No significant differences in W/∑△Vo2, Vo2rest, Vo2stea, and △Vo2 were found between COPD patients and control subjects. MRT distinguished positively correlated with O2 deficit and distinguished negatively correlated with FEV1.0, FEV1.0%, FEV1.0/FVC, W/∑△Vo2, SpO2exer, Vo2rest, and Vo2stea. ∑△Vo2 distinguished positively correlated with O2 deficit, △Vo2, and Vo2stea, and it distinguished negatively correlated with FEV1/FVC. Conclusion：The delay in oxygen uptake kinetics and higher oxygen consumption exist in COPD patients under constant workload exercise, which may be caused by air flow limitation, low rate of oxidative metabolism in exercising muscle, and hypoxemia, This may be the mechanism of exercise intolerance in COPD patients

关 键 词：肺疾病 慢性阻塞性 摄氧动力 平均反应时间 运动肌氧化代谢效能 

分 类 号：R563[医药卫生—呼吸系统]