氧疗对中重度慢性阻塞性肺疾病患者运动能力的影响  

Effects of oxygen therapy on exercise capacity in patients with stable moderate to severe COPD

作　　者：郭忠良[1] 蔡映云[1] 朱蕾[1] 梁永杰[1] 顾宇彤[1] 杨文兰[1] 

机构地区：[1]上海医科大学附属中山医院肺科

出　　处：《中国康复医学杂志》1999年第2期55-59,共5页Chinese Journal of Rehabilitation Medicine

摘　　要：目的：观察氧疗对中重度慢性阻塞性肺疾病（ＣＯＰＤ）患者运动能力、运动时血氧饱和度和生理指标的影响。方法：选择３０例中重度ＣＯＰＤ患者，应用自行车功率仪分别在吸空气和３０％氧气条件下进行两次增量运动试验。结果：在第一、第二级运动负荷时，氧疗对低氧血症组和无低氧血症组的影响十分接近。但在第三级运动负荷及最大可比负荷时氧疗能降低低氧血症组的ＶＥ、ＶＣＯ２、ＤＩ、ＨＲ、Ｂｏｒｇ评分，而对无低氧血症组则影响不明显。极量运动时氧疗可使低氧血症组总运动时间、最大运动负荷、最大每分氧耗量和运动时最低血氧饱和度均显著提高，但对每分通气量、呼吸频率、潮气量、ＣＯ２排出量、气急指数、心率和ＴＣＤ／ＶＴ等指标均无明显影响。吸氧对无低氧血症组各项指标均无显著影响。结论：氧疗能显著提高运动时低氧血症患者的运动能力和运动时最低血氧饱和度，同时降低相同运动负荷时的每分通气量、ＣＯ２排出量、心率和呼吸困难程度；氧疗对运动时无低氧血症患者能降低初始负荷运动时每分通气量和ＣＯ２排出量，但对最大运动能力无明显的影响。Objective:To evaluate effects of oxygen therapy on exercise capacity, blood oxygen saturation(SaO 2) and the parameters of exercise reaction. Method:Thirty patients with stable moderate to severe COPD were investigated. All patients performed incremental exercise test with ergometer twice while breathing either air or 30% oxygen.Result:14 patients revealed SaO 2 lower than 90% during exercise testing (hypoxemia group).The effects of oxygen therapy to patients with hypoxemia was similar to those with non hypoxemia during first and second degree workload. A significant improvement in minute ventilation (VE), carbon dioxide output (VCO 2), dyspnea index (DI) , Heart rate (HR) and Borg visual analog scale (Brog Scale) were found in hypoxemia group during third and highest degree workload while breathing 30% oxygen. Oxygen therapy to hypoxemia group could also obviously increase exercise time (Ttotl) from 3.1 to 4.5min, maximal workload(W max ) from 31 to 46W, and maximal oxygen uptake (VO 2max )from 695 to 780ml/min, and lowest SaO 2 from 85 to 95%. But no obviously increase in Ttotl, W max and VO 2max occurred to non hypoxemis group while breathing 30% oxygen. Conclusion:Oxygen therapy might provide beneficial improvements in SaO 2 and exercise capacity in patients with hypoxemia induced by exercise, improve ventilatory reaction and dyspnea, reduce heart rate and CO 2 output. But there′s little effect in those with nonhypoxemia by oxygen therapy.

关 键 词：阻塞性肺疾病 运动试验 低氧血症 氧疗法 

分 类 号：R563.06[医药卫生—呼吸系统] R549.305[医药卫生—内科学]